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NPI Code Detail

MEDICARE: MS. KELLI M CARTER M.D.

MEDICARE: MS. KELLI M CARTER 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
1207Q00000XFamily Medicine Physician041529GA

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 : 1285634212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KELLI M CARTER M.D.
Provider Business Mailing Address
First Line : 3686 WHEELER RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30909
Country : US
Telephone Number : 706-922-6300
Fax Number : 706-922-6303
Provider Business Practice Location Address
First Line : 1113 WASHINGTON RD
Second Line :
City : THOMSON
State : GA
Zip : 30824-7523
Country : US
Telephone Number : 706-595-7825
Fax Number : 706-595-1235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2005
Last Update Date : 05/10/2013

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