Provider Demographics
NPI:1609929132
Name:KARTER NEURO DIAGNOSTICS
Entity Type:Organization
Organization Name:KARTER NEURO DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LANINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-415-6464
Mailing Address - Street 1:PO BOX 1502
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72316-1502
Mailing Address - Country:US
Mailing Address - Phone:210-415-6464
Mailing Address - Fax:870-838-7770
Practice Address - Street 1:808 E PROMISE LAND RD
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-7713
Practice Address - Country:US
Practice Address - Phone:210-415-6464
Practice Address - Fax:870-838-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty