Provider Demographics
NPI:1366555674
Name:CARTER, THOMAS BENCE (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:BENCE
Last Name:CARTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2609 VILLAGE PROFESSIONAL DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5442
Mailing Address - Country:US
Mailing Address - Phone:334-749-6523
Mailing Address - Fax:334-742-0242
Practice Address - Street 1:2609 VILLAGE PROFESSIONAL DR
Practice Address - Street 2:SUITE 3
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5442
Practice Address - Country:US
Practice Address - Phone:334-749-6523
Practice Address - Fax:334-742-0242
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO175207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1366555674OtherNPI
AL51036642OtherBCBS LAFAYETTE
ALCC1726OtherRRMC
AL51028339OtherBCBS DADEVILLE
AL51028340OtherBCBS LANGDALE
AL51028341OtherBCBS TUSKEGEE
AL51028338OtherBCBS OPELIKA
AL528701590Medicaid
ALCC1726OtherRRMC