Provider Demographics
NPI:1073539821
Name:CARRIER, GARY R (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:R
Last Name:CARRIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 INDIAN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3820
Mailing Address - Country:US
Mailing Address - Phone:615-822-7421
Mailing Address - Fax:615-822-7475
Practice Address - Street 1:129 INDIAN LAKE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3820
Practice Address - Country:US
Practice Address - Phone:615-822-7421
Practice Address - Fax:615-822-7475
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3979780OtherCIGNA PROVIDER ID
TN4318508OtherAETNA
TN4442119OtherUNITEDHEALTHCARE ID
TN3040195OtherBCBS TN PROVIDER ID
TN621624469OtherEIN
TN3675981Medicare PIN
TN3040195OtherBCBS TN PROVIDER ID