MEDICARE: M GARY CARTER, MD PA

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	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1396825600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M GARY CARTER, MD PA

Provider Business Mailing Address
First Line	:	1035 N HOUSTON RD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-1505
Country	:	US
Telephone Number	:	478-923-6441
Fax Number	:	478-328-0543

Provider Business Practice Location Address
First Line	:	1035 N HOUSTON RD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-1505
Country	:	US
Telephone Number	:	478-923-6441
Fax Number	:	478-328-0543

Authorized Official
Title or Position	:	OWNER
Name	:	DR. M. GARY CARTER
Credential	:	MD
Telephone Number	:	478-923-6441

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	12/14/2007

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