Individual provider · NPI-1

Dr. Andy Bruce Carter, D.O.

Family Medicine · Crestview, FL

NPI number1144451550
StatusActive
Last updated in NPPESOct 17, 2013

Details

NPI
1144451550
Entity type
Individual (NPI-1)
Name
Dr. Andy Bruce Carter
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 3, 2009
Last updated
Oct 17, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineOS10740FLYes

Practice location

613 Red Fern Rd
Crestview, FL 32536-5472

Phone 407-733-2037

Mailing address

613 Red Fern Rd
Crestview, FL 32536-5472

Phone 407-733-2037

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