Provider Demographics
NPI:1760527766
Name:CARPENTER, JAMIE S (R MR)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:S
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:R MR
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2580 WOODFORD LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-6119
Mailing Address - Country:US
Mailing Address - Phone:404-683-6675
Mailing Address - Fax:
Practice Address - Street 1:113 FAIRVIEW PARK DR # A
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2501
Practice Address - Country:US
Practice Address - Phone:478-275-8895
Practice Address - Fax:478-275-8896
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
3549222471C3402X, 2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
Not Answered2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging