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NPI Code Detail

MEDICARE: MR. JOHN CARR TERRY MS

MEDICARE: MR. JOHN CARR TERRY MS
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
1103T00000XPsychologist468WV

Other Identifiers

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

General Provider Information

NPI Number : 1265415731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN CARR TERRY MS
Provider Business Mailing Address
First Line : PO BOX 590
Second Line :
City : UNION
State : WV
Zip : 24983-0590
Country : US
Telephone Number : 304-431-3010
Fax Number : 304-431-3011
Provider Business Practice Location Address
First Line : 2869 SENECA TRL S
Second Line :
City : PETERSTOWN
State : WV
Zip : 24963-5037
Country : US
Telephone Number : 304-431-3010
Fax Number : 304-431-3011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 01/29/2025

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