Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | E2501 | TX |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | E2501 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | E2501 | TX |
N | 207XX0801X | Orthopaedic Trauma Surgeon | E2501 | TX |
NPI | 1376629154 |
---|---|
Provider Name | Dr. John Daniel Carter |
First Address | Lufkin, TX 75904-3166 |
Second Address | Lufkin, TX 75904-3166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 21/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
089597103 | (05) | TX |
116772 | SUPERIOR (01) | TX |
4413250 | AETNA (01) | TX |
5577002001 | CIGNA (01) | TX |
CS6860 | RAIL ROAD MEDICARE (01) | TX |
D48100 | (02) | TX |