Provider Demographics
NPI:1457644312
Name:CARTER, HEATHER HAMILTON
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:HAMILTON
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-3485
Mailing Address - Country:US
Mailing Address - Phone:931-728-4718
Mailing Address - Fax:931-728-1016
Practice Address - Street 1:482 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-3485
Practice Address - Country:US
Practice Address - Phone:931-728-4718
Practice Address - Fax:931-728-1016
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN091354951207Q00000X
TN2701207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine