Provider Demographics
NPI:1164774667
Name:PHYSICIAN ON-CALL NOW LLC
Entity Type:Organization
Organization Name:PHYSICIAN ON-CALL NOW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:571-247-1876
Mailing Address - Street 1:9569 ENGLISH IVY CT
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-6962
Mailing Address - Country:US
Mailing Address - Phone:571-247-1876
Mailing Address - Fax:
Practice Address - Street 1:9569 ENGLISH IVY CT
Practice Address - Street 2:
Practice Address - City:FORTSON
Practice Address - State:GA
Practice Address - Zip Code:31808-6962
Practice Address - Country:US
Practice Address - Phone:571-247-1876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065088207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Multi-Specialty