Provider Demographics
NPI:1235263971
Name:CARLTON, THOMAS KERN III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KERN
Last Name:CARLTON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-4375
Mailing Address - Country:US
Mailing Address - Phone:704-375-8900
Mailing Address - Fax:704-335-7178
Practice Address - Street 1:2610 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-4375
Practice Address - Country:US
Practice Address - Phone:704-375-8900
Practice Address - Fax:704-335-7178
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300056225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
BC3691006OtherDEA NUMBER
BC3691006OtherDEA NUMBER
NCF54648Medicare UPIN