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General NPI Number Information
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NPI Number | 1124493606
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Entity Type | Individual
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Provider Name | OWEN JEFFERY CARR PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 2709 MEREDYTH DR STE 450
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City | ALBANY
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State | GA
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Zip | 31707-0220
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Country | US
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Telephone | 229-446-1990
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Fax | 229-312-5005
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Provider Business Mailing Address
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Address Line | 2709 MEREDYTH DR STE 450
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City | ALBANY
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State | GA
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Zip | 31707-0220
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Country | US
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Telephone | 229-446-1990
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Fax | 229-312-5005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | GA
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