Provider Demographics
NPI:1215222567
Name:CARPENTER, LAUREN ANN (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 N HOUSTON RD
Mailing Address - Street 2:STE 140E
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:233 N HOUSTON RD STE 140E
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3023
Practice Address - Country:US
Practice Address - Phone:478-975-6880
Practice Address - Fax:478-975-6869
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA154085207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine