Individual
GARY B. CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036095444
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095444
—
IL
Enumeration date
01/10/2006
Last updated
11/14/2008
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