Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 2011001440 | MO |
N | 2086S0129X | Vascular Surgeon | 42797 | KY |
NPI | 1083645402 |
---|---|
Provider Name | Dr. Robert Rick Carter |
First Address | Kansas City, MO 64116-3237 |
Second Address | Kansas City, MO 64116-3237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 27/01/2014 |