Provider Demographics
NPI:1821106626
Name:CARTER, CHRISTOPHER COLEMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:COLEMAN
Last Name:CARTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2537 ARLINGTON CRES
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4105
Mailing Address - Country:US
Mailing Address - Phone:205-960-5331
Mailing Address - Fax:
Practice Address - Street 1:750 ACADEMY DR
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5200
Practice Address - Country:US
Practice Address - Phone:205-424-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-675-TA-160152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU16740Medicare UPIN
ALU16740Medicare UPIN