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General NPI Number Information
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NPI Number | 1689606675
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Entity Type | Individual
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Provider Name | THOMAS CHARLES CARPENTER
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 300 NORTH AVE.
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City | 300 NORTH AVE.
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State | MI
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Zip | 49016
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Country | US
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Telephone | 616-966-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 FRANTZ RD 250
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City | DUBLIN
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State | OH
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Zip | 43016-6102
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Country | US
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Telephone | 614-544-6161
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Fax | 614-544-6370
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | COA01223NA
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License Number State | OH
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