Healthcare Provider Details

I. General information

NPI: 1134287717
Provider Name (Legal Business Name): CARLOTA OB GYN P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 W MARKET ST SUITE 9
ATHENS AL
35611-2454
US

IV. Provider business mailing address

1005 W MARKET ST SUITE 9
ATHENS AL
35611-2454
US

V. Phone/Fax

Practice location:
  • Phone: 256-233-3100
  • Fax: 256-233-2277
Mailing address:
  • Phone: 256-233-3100
  • Fax: 256-233-2277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. OLIVER E CARLOTA
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 256-233-3100