Healthcare Provider Details

I. General information

NPI: 1609806439
Provider Name (Legal Business Name): CALPHOR S CARTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 TARA LN
HUNTINGDON TN
38344-2107
US

IV. Provider business mailing address

375 TARA LN
HUNTINGDON TN
38344-2107
US

V. Phone/Fax

Practice location:
  • Phone: 731-415-6683
  • Fax:
Mailing address:
  • Phone: 731-415-6683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number038761
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: