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General NPI Number Information
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NPI Number | 1144525395
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Entity Type | Individual
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Provider Name | MICKIE CARTER MS, PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 284 HWY 641 N
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City | CAMDEN
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State | TN
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Zip | 38320
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Country | US
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Telephone | 903-724-4266
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Fax |
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Provider Business Mailing Address
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Address Line | 147 WHITEHEAD RD
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City | PARIS
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State | TN
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Zip | 38242-7737
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Country | US
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Telephone | 903-724-4266
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Fax |
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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 | 1731
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License Number State | TN
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