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General NPI Number Information
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NPI Number | 1578429213
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Entity Type | Organization
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Legal Business Name | T CARTER LLC
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 1610 ALICE ST
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City | WAYCROSS
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State | GA
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Zip | 31501-4533
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Country | US
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Telephone | 912-550-7091
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Fax |
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Provider Business Mailing Address
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Address Line | 903 AZALEA ST
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City | BLACKSHEAR
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State | GA
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Zip | 31516-2337
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NP
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Name | TIERRA CARTER
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Credential | NP
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Telephone | 912-550-7091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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