Healthcare Provider Details

I. General information

NPI: 1225864838
Provider Name (Legal Business Name): DR. KEVIN CARTER SLEEP CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 COMMONS BLVD STE 110
BEAVERCREEK OH
45431-3827
US

IV. Provider business mailing address

2633 COMMONS BLVD STE 110
BEAVERCREEK OH
45431-3827
US

V. Phone/Fax

Practice location:
  • Phone: 937-705-6747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEVIN CARTER
Title or Position: OWNER
Credential: DO
Phone: 571-247-1876