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General NPI Number Information
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NPI Number | 1356343040
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Entity Type | Individual
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Provider Name | ROBERT JAY CARPENTER III D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 4051 BARRANCAS AVE SUITE G, PMB 219
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City | PENSACOLA
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State | FL
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Zip | 32507-3492
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Country | US
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Telephone | 850-723-9068
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Fax | 888-217-1652
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Provider Business Mailing Address
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Address Line | 4051 BARRANCAS AVE SUITE G, PMB 219
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City | PENSACOLA
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State | FL
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Zip | 32507-3492
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Country | US
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Telephone | 850-723-9068
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Fax | 888-217-1652
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 20A 10964
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS13142
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License Number State | FL
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