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NPI Code Detail

MEDICARE: DR. WILLIAM C CARR JR. M.D.

MEDICARE: DR. WILLIAM C CARR JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician15856MS
2207P00000XEmergency Medicine Physician2008023872MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154300135
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM C CARR JR. M.D.
Provider Business Mailing Address
First Line : 1818 TIMBER CREEK RD.
Second Line :
City : STARKVILLE
State : MS
Zip : 39759
Country : US
Telephone Number : 662-338-5053
Fax Number : 662-615-2554
Provider Business Practice Location Address
First Line : 400 HOSPITAL RD
Second Line :
City : STARKVILLE
State : MS
Zip : 39759-2163
Country : US
Telephone Number : 662-615-2503
Fax Number : 662-615-2554
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2006
Last Update Date : 11/19/2008

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