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General NPI Number Information
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NPI Number | 1609842012
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Entity Type | Individual
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Provider Name | RUSSELL H CARTER MD
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 03/06/2019
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Provider Practice Location Address
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Address Line | 1443 COUNTY ROAD 103
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City | GEORGETOWN
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State | TX
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Zip | 78626-3854
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Country | US
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Telephone | 512-783-7889
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Fax | 512-732-7310
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Provider Business Mailing Address
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Address Line | 707 W JOHANNA ST UNIT A
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City | AUSTIN
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State | TX
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Zip | 78704-4127
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Country | US
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Telephone | 512-732-7310
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Fax | 512-732-7309
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD424339
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME93460
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD5086
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License Number State | TX
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