Individual
SAMUEL R CARTER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2024 S MAIDEN LN STE 203, JOPLIN, MO 64804-0319
(417) 659-4661
(417) 659-8509
Mailing address
2024 S MAIDEN LN STE 203, JOPLIN, MO 64804-0319
(417) 659-4661
(417) 659-8509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
109788
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100069440A
—
OK
05
—
100188880A
—
KS
01
—
110136988
RR MEDICARE
—
05
—
208238105
—
MO
01
—
31655
ANTHEM
MO
Enumeration date
06/22/2006
Last updated
08/28/2023
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