Provider Demographics
NPI:1649278219
Name:CARR, JOHN PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:CARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3624 J DEWEY GRAY CIR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6584
Mailing Address - Country:US
Mailing Address - Phone:706-855-5650
Mailing Address - Fax:706-863-0821
Practice Address - Street 1:3624 J DEWEY GRAY CIR
Practice Address - Street 2:SUITE 308
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6584
Practice Address - Country:US
Practice Address - Phone:706-855-5650
Practice Address - Fax:706-863-0821
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2012-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA15655207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD39555Medicare UPIN
GA202I081301Medicare PIN
GA000205059AMedicare ID - Type Unspecified