Provider Demographics
NPI:1750367199
Name:CARTTAR, CHARLES D (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:D
Last Name:CARTTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4601 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3860
Mailing Address - Country:US
Mailing Address - Phone:501-664-0769
Mailing Address - Fax:501-664-9558
Practice Address - Street 1:4601 WOODLAWN DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3860
Practice Address - Country:US
Practice Address - Phone:501-664-0769
Practice Address - Fax:501-664-9558
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC5828207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR111257001Medicaid
AR111257001Medicaid
ARB90054Medicare UPIN