Provider Demographics
NPI:1184663452
Name:CARTER, JOHN LEROY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEROY
Last Name:CARTER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2801 N DECATUR RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5949
Mailing Address - Country:US
Mailing Address - Phone:404-299-9307
Mailing Address - Fax:404-299-9309
Practice Address - Street 1:2801 N DECATUR RD
Practice Address - Street 2:SUITE 190
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5949
Practice Address - Country:US
Practice Address - Phone:404-299-9307
Practice Address - Fax:404-299-9309
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA019920207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4030696OtherAETNA/USHC
GA0528515OtherAETNA/USHC
GA000450953FMedicaid
GA202I163174OtherMEDICARE PTAN
GA618195OtherBLUE CROSS BLUE SHIELD
GA000450953GMedicaid
GA160040031OtherRAILROAD MEDICARE
GA0702314OtherUNITED HEALTHCARE
GA202I163174OtherMEDICARE PTAN