Provider Demographics
NPI:1518923861
Name:CARTER, JAMES MARK (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MARK
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:101 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-3363
Mailing Address - Country:US
Mailing Address - Phone:479-968-2345
Mailing Address - Fax:479-890-2467
Practice Address - Street 1:1600 W C PL
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2705
Practice Address - Country:US
Practice Address - Phone:479-967-7717
Practice Address - Fax:866-280-8464
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2020-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC-4070207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR103847001Medicaid
AR103847001Medicaid
AR50915Medicare PIN