Basic Information
| Provider Information | |||||||||
| NPI: | 1154400851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARTER | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 636256 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135855502 | ||||||||
| FaxNumber: | 5135855511 | ||||||||
| Practice Location | |||||||||
| Address1: | 7000 UULA ST | ||||||||
| Address2: | |||||||||
| City: | BARROW | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9078529277 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2006 | ||||||||
| LastUpdateDate: | 07/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35 091520 | OH | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | J3291 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 161463 | AK | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 2848584 | 05 | OH | MEDICAID | 200903120 | 05 | IN | MEDICAID | 7100106110 | 05 | KY | MEDICAID |