Individual
JENNIFER PEEPLES CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
619 DIXIE ST, CARROLLTON, GA 30117-3816
(770) 834-0212
(770) 834-0213
Mailing address
619 DIXIE ST, CARROLLTON, GA 30117-3816
(770) 834-0212
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002081
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24591
SPECTERA
GA
01
—
550882371
BCBS
GA
05
—
793136480A
—
GA
Enumeration date
08/18/2005
Last updated
01/21/2016
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