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General NPI Number Information
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NPI Number | 1528880002
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Entity Type | Individual
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Provider Name | CARTER CROSS CPO
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Gender | Male
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1820 N COLUMBIA ST STE F
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-7166
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Country | US
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Telephone | 478-295-3240
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 N COLUMBIA ST STE F
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-7166
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Country | US
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Telephone | 478-295-3240
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | 224
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | 224
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License Number State | GA
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