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NPI Code Detail

MEDICARE: MR. ROBERT A CARPENTER I

MEDICARE: MR. ROBERT A CARPENTER I
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1215861331
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT A CARPENTER I
Provider Business Mailing Address
First Line : 3112 CHARLESTON ST NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-2202
Country : US
Telephone Number : 505-670-5347
Fax Number :
Provider Business Practice Location Address
First Line : 4201 CARLISLE BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87107-4808
Country : US
Telephone Number : 505-670-5347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “ MR. ROBERT A CARPENTER I ” Practice Location

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