MEDICARE: DR. EDWARD A. CARRINGTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9227	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	080194927	OTHER	AZ	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0100151	OTHER	AZ	UNITED HEALTHCARE
2	21079227	OTHER	AZ	ICA
3	4057973	OTHER	AZ	AETNA
5	2400601J	OTHER	AZ	DES
6	ZA0361080	OTHER	AZ	BLUE CROSS/BLUE SHIELD
7	00140106	OTHER	AZ	BANNER
8	1078501	OTHER	AZ	CIGNA HEALTHCARE

General Provider Information

NPI Number	:	1093715914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD A. CARRINGTON M.D.

Provider Business Mailing Address
First Line	:	2204 S DOBSON RD STE 101
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85202-6457
Country	:	US
Telephone Number	:	480-912-3510
Fax Number	:	480-912-3514

Provider Business Practice Location Address
First Line	:	2204 S DOBSON RD STE 101
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85202-6457
Country	:	US
Telephone Number	:	480-912-3510
Fax Number	:	480-912-3514

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/23/2018

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Directions to “ DR. EDWARD A. CARRINGTON M.D.” Practice Location

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