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NPI Code Detail

MEDICARE: DR. JOHN F CARMACK MD

MEDICARE: DR. JOHN F CARMACK MD
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 Physician0101045367VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2080167980OTHERMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1066035OTHERANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639152812
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN F CARMACK MD
Provider Business Mailing Address
First Line : PO BOX 389
Second Line :
City : FOREST
State : VA
Zip : 24551-0389
Country : US
Telephone Number : 434-552-5696
Fax Number : 434-525-4035
Provider Business Practice Location Address
First Line : 1175 CORPORATE PARK DR
Second Line :
City : FOREST
State : VA
Zip : 24551-2238
Country : US
Telephone Number : 434-525-6964
Fax Number : 434-525-4035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 08/13/2013

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