Provider Demographics
NPI:1972505360
Name:HALE, CARTER JOE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARTER
Middle Name:JOE
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 SMYTH RD
Mailing Address - Street 2:VAMC
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104
Mailing Address - Country:US
Mailing Address - Phone:603-624-4366
Mailing Address - Fax:603-626-6559
Practice Address - Street 1:4100 GOSS RD
Practice Address - Street 2:FOX ARMY HEALTH CENTER
Practice Address - City:REDSTONE ARSENAL
Practice Address - State:AL
Practice Address - Zip Code:35809
Practice Address - Country:US
Practice Address - Phone:256-955-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17884207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF99213Medicare UPIN