Individual
DR. CLINTON JOHN CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M3958
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076PA
BCBS
TX
05
—
106454512
—
TX
05
—
184728701
—
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
750818167022
TRICARE
TX
01
—
8EX119
BCBS
TX
01
—
8X8162
BCBS
TX
01
—
P01490696
RAIL ROAD
TX
Enumeration date
09/14/2006
Last updated
03/31/2016
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