Provider Demographics
NPI:1447305222
Name:M GARY CARTER MD
Entity type:Organization
Organization Name:M GARY CARTER MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-745-2881
Mailing Address - Street 1:1867 FORSYTH ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1166
Mailing Address - Country:US
Mailing Address - Phone:478-745-2881
Mailing Address - Fax:478-746-5749
Practice Address - Street 1:1867 FORSYTH ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1166
Practice Address - Country:US
Practice Address - Phone:478-745-2881
Practice Address - Fax:478-746-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE53949Medicare UPIN
GA4158210002Medicare NSC