Healthcare Provider Details

I. General information

NPI: 1194700054
Provider Name (Legal Business Name): DAVID A CARR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 SOUTH 65 HIGHWAY, BUILDING A
MARSHALL MO
65340-3702
US

IV. Provider business mailing address

2305 SOUTH 65 HIGHWAY, BUILDING A
MARSHALL MO
65340-3702
US

V. Phone/Fax

Practice location:
  • Phone: 660-886-6677
  • Fax: 660-831-3346
Mailing address:
  • Phone: 660-886-7431
  • Fax: 660-886-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberR5810
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: