Healthcare Provider Details

I. General information

NPI: 1043673742
Provider Name (Legal Business Name): JOSEPH CARR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 TEAL RD STE 8
LAFAYETTE IN
47905-2463
US

IV. Provider business mailing address

9202 N MERIDIAN ST
INDIANAPOLIS IN
46260-1804
US

V. Phone/Fax

Practice location:
  • Phone: 317-841-2020
  • Fax:
Mailing address:
  • Phone: 317-841-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number01083764A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number53795
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: