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General NPI Number Information
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NPI Number | 1396980249
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Entity Type | Organization
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Legal Business Name | RICHARD O. CARPENTER, M.D., P.C.
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Dates
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Enumeration Date | 12/06/2008
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Last Update Date | 12/06/2008
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Provider Practice Location Address
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Address Line | 14 NORCROSS ST
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City | ROSWELL
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State | GA
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Zip | 30075-3810
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Country | US
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Telephone | 800-843-8216
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Fax | 770-650-2668
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Provider Business Mailing Address
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Address Line | 5450 ERROL PL NW
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City | ATLANTA
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State | GA
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Zip | 30327-4869
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Country | US
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Telephone | 800-843-8216
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Fax | 770-650-2668
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD OWEN CARPENTER
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Credential | M.D.
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Telephone | 800-843-8216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 037165
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License Number State | GA
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