Provider Demographics
NPI:1417946674
Name:CARTER, ANN DEGROFF (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:DEGROFF
Last Name:CARTER
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 1:8404 CORTELAND DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909
Mailing Address - Country:US
Mailing Address - Phone:865-250-0694
Mailing Address - Fax:865-835-5139
Practice Address - Street 1:8404 CORTELAND DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:865-250-0694
Practice Address - Fax:865-835-5139
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000015858207Q00000X
TN15858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3012635Medicaid
TN3012635Medicaid
TN30126351Medicare PIN
TNB58878Medicare UPIN