Organization
DARRELL W. CARPENTER, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL W CARPENTER MD (PRESIDENT)
(229) 248-0011
Entity
Organization
Contact information
Practice address
603 WHEAT AVE, SUITE 400, BAINBRIDGE, GA 39819-4360
(229) 248-0011
(229) 248-0408
Mailing address
603 WHEAT AVE, SUITE 400, BAINBRIDGE, GA 39819-4360
(229) 248-0011
(229) 248-0408
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
040023
GA
208000000X
Pediatrics Physician
RN129224
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006556752B
—
GA
Enumeration date
11/28/2007
Last updated
11/28/2007
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