Provider Demographics
NPI:1205858750
Name:CARR, FELICIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:M
Last Name:CARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:GLORIA
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:602 E. 72ND STREET
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4913
Mailing Address - Country:US
Mailing Address - Phone:912-819-7878
Mailing Address - Fax:912-819-5044
Practice Address - Street 1:527 EISENHOWER DRIVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1612
Practice Address - Country:US
Practice Address - Phone:912-819-9100
Practice Address - Fax:912-819-9101
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000413553DMedicaid
GA000413553FMedicaid
GA52570824-004OtherBCBS ID
GA000413553EMedicaid
GA000413553GMedicaid
GA000413553GMedicaid
GAP00418170Medicare PIN
GA08CBBTJMedicare PIN
GA000413553FMedicaid
GA52570824-004OtherBCBS ID