Provider Demographics
NPI:1134594401
Name:ROSSANA Y CARTER, MD, LLC
Entity type:Organization
Organization Name:ROSSANA Y CARTER, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:COLLINS
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-742-8760
Mailing Address - Street 1:330 HOSPITAL DR STE 304
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-8046
Mailing Address - Country:US
Mailing Address - Phone:478-742-1010
Mailing Address - Fax:478-742-9666
Practice Address - Street 1:330 HOSPITAL DR STE 304
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-8046
Practice Address - Country:US
Practice Address - Phone:478-742-1010
Practice Address - Fax:478-742-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty