Provider Demographics
NPI:1164078945
Name:CARTER, BYRON ALLAN
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:ALLAN
Last Name:CARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 270TH ST
Mailing Address - Street 2:
Mailing Address - City:COIN
Mailing Address - State:IA
Mailing Address - Zip Code:51636
Mailing Address - Country:US
Mailing Address - Phone:712-246-8500
Mailing Address - Fax:
Practice Address - Street 1:1430 270TH ST
Practice Address - Street 2:
Practice Address - City:COIN
Practice Address - State:IA
Practice Address - Zip Code:51636
Practice Address - Country:US
Practice Address - Phone:712-246-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider