Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 33626 | NC |
NPI | 1104887850 |
---|---|
Provider Name | Dr. Richard Alan Carlton |
First Address | Hickory, NC 28601-5057 |
Second Address | Hickory, NC 28601-5057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 15/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3760384 | CAROLINA CARE PLAN (PHP) (01) | NC |
8921144 | (05) | NC |
E07605 | (02) | NC |