Provider Demographics
NPI:1922030014
Name:CARTER, JODIANNE THERESE (MD)
Entity Type:Individual
Prefix:DR
First Name:JODIANNE
Middle Name:THERESE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8901 W 74TH ST
Mailing Address - Street 2:SUITE 285
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2204
Mailing Address - Country:US
Mailing Address - Phone:913-362-3210
Mailing Address - Fax:913-362-0407
Practice Address - Street 1:8800 W 75TH ST STE 140
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-4001
Practice Address - Country:US
Practice Address - Phone:913-362-3210
Practice Address - Fax:913-362-0407
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-05-09
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Provider Licenses
StateLicense IDTaxonomies
KS0429080207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG25095Medicare UPIN