Provider Demographics
NPI:1295960623
Name:CARPENTER, HARRY GOFF JR (MD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:GOFF
Last Name:CARPENTER
Suffix:JR
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 1:5 LOON LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04270-4836
Mailing Address - Country:US
Mailing Address - Phone:207-539-4328
Mailing Address - Fax:
Practice Address - Street 1:5 LOON LN
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:ME
Practice Address - Zip Code:04270-4836
Practice Address - Country:US
Practice Address - Phone:207-539-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28982208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics