Provider Demographics
NPI:1831125822
Name:CARR, ANN M III (M D)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:CARR
Suffix:III
Gender:F
Credentials:M D
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 2699
Mailing Address - Street 2:ATTN SHMG/HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-416-2250
Mailing Address - Fax:850-416-2536
Practice Address - Street 1:5153 N 9TH AVE STE 302
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5719
Practice Address - Country:US
Practice Address - Phone:850-416-2250
Practice Address - Fax:850-416-2536
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94069207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273707800Medicaid
FL273707800Medicaid
FL29588ZMedicare ID - Type Unspecified