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General NPI Number Information
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NPI Number | 1710970520
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Entity Type | Individual
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Provider Name | CARTER JAMESON MCCORMACK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1012 MEDICAL RIDGE RD
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City | CLINTON
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State | SC
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Zip | 29325-4542
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Country | US
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Telephone | 864-833-3852
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Fax | 864-938-0501
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Provider Business Mailing Address
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Address Line | 1 INDEPENDENCE PT STE 212
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City | GREENVILLE
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State | SC
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Zip | 29615-4536
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Country | US
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Telephone | 864-797-6303
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Fax | 864-797-6198
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 33343
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2024-00957
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License Number State | NC
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