Individual
DR. DALLAS ARTHUR CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4520
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18088
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052410
—
OR
01
—
1407812365
NBMC NPI NUMBER-GROUP
OR
01
—
930635514
GROUP TAX ID
OR
01
—
CB3544
RR MEDICARE GROUP NUMBER
OR
01
—
MD18088
MEDICAL LICENSE OREGON
OR
01
—
P00281134
RR MEDICARE PTAN NUMBER
OR
01
—
R0000WFBTV
GROUP PIN NUMBER
OR
Enumeration date
12/05/2005
Last updated
05/20/2013
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