Provider Demographics
NPI:1265523005
Name:CARLEY, JEFFREY P (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:CARLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 96860
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28296-6860
Mailing Address - Country:US
Mailing Address - Phone:704-734-4550
Mailing Address - Fax:704-734-4540
Practice Address - Street 1:827 E KING ST
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3186
Practice Address - Country:US
Practice Address - Phone:704-734-4550
Practice Address - Fax:704-734-4540
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01504207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902212Medicaid
NCH67129Medicare UPIN
NC5902212Medicaid