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NPI Code Detail

MEDICARE: DOUGLAS B CARR M.D.

MEDICARE: DOUGLAS B CARR 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 Physician35068864COH

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 : 1912909219
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS B CARR M.D.
Provider Business Mailing Address
First Line : PO BOX 188
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-0188
Country : US
Telephone Number : 740-773-4366
Fax Number : 740-775-7855
Provider Business Practice Location Address
First Line : 30381 CHIEFTAIN DR
Second Line :
City : LOGAN
State : OH
Zip : 43138-9092
Country : US
Telephone Number : 740-385-2555
Fax Number : 740-380-3750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 11/05/2019

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