Provider Demographics
NPI:1538113675
Name:MCCARTER, JOSEPH JEROME (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JEROME
Last Name:MCCARTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1217
Mailing Address - Country:US
Mailing Address - Phone:304-428-8300
Mailing Address - Fax:304-428-5087
Practice Address - Street 1:4315 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1217
Practice Address - Country:US
Practice Address - Phone:304-428-8300
Practice Address - Fax:304-428-5087
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0131903000Medicaid
MC0443252Medicare PIN
WV0131903000Medicaid