Provider Demographics
NPI:1134331226
Name:GEORGE R. CARLTON JR.
Entity Type:Organization
Organization Name:GEORGE R. CARLTON JR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:256-249-9339
Mailing Address - Street 1:20 S DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2951
Mailing Address - Country:US
Mailing Address - Phone:256-249-9339
Mailing Address - Fax:
Practice Address - Street 1:20 S DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2951
Practice Address - Country:US
Practice Address - Phone:256-249-9339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51004040OtherBLUE CROSS BLUE SHIELD
AL0656980001Medicare NSC
AL6129010001Medicare NSC