Provider Demographics
NPI:1295823623
Name:CARTER, FRANCHON RENEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:FRANCHON
Middle Name:RENEE
Last Name:CARTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:FRANCHON
Other - Middle Name:RENEE
Other - Last Name:SCALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:122 GORDON COMMERCIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240
Mailing Address - Country:US
Mailing Address - Phone:706-845-4054
Mailing Address - Fax:706-845-4430
Practice Address - Street 1:59 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263
Practice Address - Country:US
Practice Address - Phone:678-423-4610
Practice Address - Fax:770-254-7419
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4728363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ64858Medicare UPIN