Individual
MR. JEFFREY WAYNE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1809 7TH AVENUE NORTH, COLUMBUS, MS 39701
(662) 251-1064
Mailing address
P.O.BOX 8774, COLUMBUS, MS 39701
(662) 251-1064
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
972770
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
972770
BUSINESS ID
MS
Enumeration date
12/13/2010
Last updated
12/13/2010
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