Provider Demographics
NPI:1477618833
Name:CARTER, JOANNA (OD)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:PLAVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:814 E JACKSON ST
Mailing Address - Street 2:STE A
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6011
Mailing Address - Country:US
Mailing Address - Phone:503-319-7939
Mailing Address - Fax:
Practice Address - Street 1:814 E JACKSON ST
Practice Address - Street 2:STE A
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6011
Practice Address - Country:US
Practice Address - Phone:541-664-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3135152WC0802X, 152WP0200X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy