Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 04650 | IA |
NPI | 1720282742 |
---|---|
Provider Name | Dr. Craig V Carr |
First Address | Iowa City, IA 52240-4517 |
Second Address | Iowa City, IA 52240-4517 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |