Provider Demographics
NPI:1093919912
Name:CARTER, BENJAMIN GILL (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:GILL
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 E RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4477
Mailing Address - Country:US
Mailing Address - Phone:435-628-6466
Mailing Address - Fax:435-628-3845
Practice Address - Street 1:1068 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4477
Practice Address - Country:US
Practice Address - Phone:435-628-6466
Practice Address - Fax:435-628-3845
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7589986-1205207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology