Healthcare Provider Details

I. General information

NPI: 1386849156
Provider Name (Legal Business Name): KEVIN STERLING CARTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

IV. Provider business mailing address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-5664
  • Fax: 520-324-4156
Mailing address:
  • Phone: 520-324-2308
  • Fax: 520-324-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50268
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number50268
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: