Provider Demographics
NPI:1295140747
Name:CARNES, ALAN KEITH JR (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:KEITH
Last Name:CARNES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1150 GOLDEN WAY
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7712
Mailing Address - Country:US
Mailing Address - Phone:706-612-9401
Mailing Address - Fax:706-612-9420
Practice Address - Street 1:1150 GOLDEN WAY
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7712
Practice Address - Country:US
Practice Address - Phone:706-612-9401
Practice Address - Fax:706-612-9420
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2024-08-09
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Provider Licenses
StateLicense IDTaxonomies
GA82345208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003223203AMedicaid