Provider Demographics
NPI:1720180615
Name:CARTER, GAYLON (DC)
Entity Type:Individual
Prefix:DR
First Name:GAYLON
Middle Name:
Last Name:CARTER
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:PO BOX 190431
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72219-0431
Mailing Address - Country:US
Mailing Address - Phone:501-217-9355
Mailing Address - Fax:501-217-9354
Practice Address - Street 1:301 N SHACKLEFORD RD
Practice Address - Street 2:SUITE F1
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2843
Practice Address - Country:US
Practice Address - Phone:501-217-9355
Practice Address - Fax:501-217-9354
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59083Medicaid
AR59083Medicaid