Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 01068538A | IN |
Y | 207QS0010X | Family Doctor - Sports Medicine | 01068538A | IN |
N | 207QS0010X | Family Doctor - Sports Medicine | 04-35771 | KS |
NPI | 1245467281 |
---|---|
Provider Name | Kile J. Carter |
First Address | Anderson, IN 46013-9684 |
Second Address | Anderson, IN 46013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2009 |
Last Update Date | 04/06/2018 |