Provider Demographics
NPI:1790216653
Name:CARR, PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:CARR
Suffix:
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 1:104 J E BRISCOE WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-4822
Mailing Address - Country:US
Mailing Address - Phone:256-705-3000
Mailing Address - Fax:256-705-3105
Practice Address - Street 1:104 J E BRISCOE WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-4822
Practice Address - Country:US
Practice Address - Phone:256-705-3000
Practice Address - Fax:256-705-3105
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ALMD.45116207N00000X
VA0101271824207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program