Organization
CARTER P FENTON SR CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARTER P FENTON DO (PRESIDENT)
(573) 887-3688
Entity
Organization
Contact information
Practice address
206 S MAIN ST, CHAFFEE, MO 63740-1002
(573) 887-3688
(573) 887-9022
Mailing address
PO BOX 98, CHAFFEE, MO 63740-0098
(573) 887-3688
(573) 887-9022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31606
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240965905
—
MO
Enumeration date
08/20/2010
Last updated
04/03/2019
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