1538165261

Everything you always wanted to know about CARTER A HARRY M.D. but were afraid to ask.

CARTER A HARRY M.D.

You can also download the this 1538165261 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
CARTER A HARRY M.D.
Gender:
Male
Enumeration date:
2005-06-27
Last update date:
2012-06-19
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
036057125 Medicaid none IL

Taxonomies

Taxonomy State License Number Primary?
207Q00000X Family Medicine IL 036096820 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 6187242401
Practice Location Address Telephone Number 6188424470
Practice Location Address Fax Number 6188423437
Mailing Address Fax Number 6187242571

Addresses

Type Address City State Postal Country
Mailing Address PO BOX 155 CHRISTOPHER IL 62822 IL
Practice Location Address 209 NW 11TH ST FAIRFIELD IL 62837 IL

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