Provider Demographics
NPI:1437422557
Name:VEST, CARTER E (PA)
Entity Type:Individual
Prefix:MRS
First Name:CARTER
Middle Name:E
Last Name:VEST
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 409
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-0011
Mailing Address - Country:US
Mailing Address - Phone:706-769-4852
Mailing Address - Fax:706-769-8372
Practice Address - Street 1:774 ATHENS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:GA
Practice Address - Zip Code:30648-1908
Practice Address - Country:US
Practice Address - Phone:706-743-8183
Practice Address - Fax:706-743-8183
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6418363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical