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NPI Code Detail

MEDICARE: RICHARD S. CARLEY M.D.

MEDICARE: RICHARD S. CARLEY 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
1207P00000XEmergency Medicine Physician9900789NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194723882
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD S. CARLEY M.D.
Provider Business Mailing Address
First Line : 924 N HOWE ST
Second Line :
City : SOUTHPORT
State : NC
Zip : 28461-3038
Country : US
Telephone Number : 910-457-3800
Fax Number :
Provider Business Practice Location Address
First Line : 240 HOSPITAL DR NE
Second Line :
City : BOLIVIA
State : NC
Zip : 28422-8346
Country : US
Telephone Number : 843-497-5929
Fax Number : 843-497-6601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 05/06/2017

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