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NPI Code Detail

MEDICARE: CHARLES WILLIAM CARTER III CCC-SLP

MEDICARE: CHARLES WILLIAM CARTER III CCC-SLP
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
1235Z00000XSpeech-Language PathologistSP4217AR

General Provider Information

NPI Number : 1316404494
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES WILLIAM CARTER III CCC-SLP
Provider Business Mailing Address
First Line : 8701 RILEY DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6509
Country : US
Telephone Number : 501-224-2700
Fax Number :
Provider Business Practice Location Address
First Line : 8701 RILEY DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6509
Country : US
Telephone Number : 501-224-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2019
Last Update Date : 02/26/2019

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Directions to “ CHARLES WILLIAM CARTER III CCC-SLP” Practice Location

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