Provider Demographics
NPI:1619988334
Name:CARR, EUGENE JOSEPH JR (DPM)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:JOSEPH
Last Name:CARR
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6123
Mailing Address - Country:US
Mailing Address - Phone:239-262-6765
Mailing Address - Fax:239-262-1321
Practice Address - Street 1:275 8TH ST S
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6123
Practice Address - Country:US
Practice Address - Phone:239-262-6765
Practice Address - Fax:239-262-1321
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1290213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U11583Medicare UPIN
FL87698ZMedicare ID - Type Unspecified