Healthcare Provider Details

I. General information

NPI: 1720186539
Provider Name (Legal Business Name): WILLIAM J CARTER M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DRIVE
NORTH LITTLE ROCK AR
72114
US

IV. Provider business mailing address

9815 SATTERFIELD DR
LITTLE ROCK AR
72205-1517
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-2061
  • Fax: 501-257-2059
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberC-3180
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: