Provider Demographics
NPI:1518370899
Name:CARPENTER, JOSHUA TRENT (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:TRENT
Last Name:CARPENTER
Suffix:
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:HOME TOWN DIRECT CARE
Mailing Address - Street 2:111N LAFAYETTE ST
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150
Mailing Address - Country:US
Mailing Address - Phone:704-721-2063
Mailing Address - Fax:704-789-2090
Practice Address - Street 1:111 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150
Practice Address - Country:US
Practice Address - Phone:704-214-1069
Practice Address - Fax:844-927-4953
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201957390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program