MEDICARE: DR. JAMES DAVID CARTER D.C.

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
1	111N00000X	Chiropractor	1182	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35001634	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1205837846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DAVID CARTER D.C.

Provider Business Mailing Address
First Line	:	PO BOX 966
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-0966
Country	:	US
Telephone Number	:	479-524-8379
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 S MOUNT OLIVE ST
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-3609
Country	:	US
Telephone Number	:	479-524-8379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	07/08/2007

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