Provider Demographics
NPI:1912901331
Name:CARTER, KENNETH B (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:B
Last Name:CARTER
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 1:2201 MURPHY AVE
Mailing Address - Street 2:STE 411
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1888
Mailing Address - Country:US
Mailing Address - Phone:615-321-3605
Mailing Address - Fax:615-321-3629
Practice Address - Street 1:2201 MURPHY AVE
Practice Address - Street 2:STE 411
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1888
Practice Address - Country:US
Practice Address - Phone:615-321-3605
Practice Address - Fax:615-321-3629
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
TN17418207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3375718Medicare ID - Type Unspecified