Charles Jackie Carpenter Jr., MD

Surgery Physician · Dothan, AL

Individual Active NPI

NPI number 1073508404

Practice location

4300 W Main St Ste 21
Dothan, AL 36305-1058
Phone
(334) 793-9564
Fax
(334) 671-8907

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NPI record

NPI
1073508404
Entity type
Individual (Type 1)
Enumeration date
September 12, 2005
Last updated
March 3, 2021
Certified
March 3, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgery Physician Primary 208600000X 17706 AL

Mailing address

PO Box 6599
Dothan, AL 36302-6599
Phone
(334) 699-7900
Fax
(334) 699-7901

About Dr. Carpenter

Charles Jackie Carpenter Jr., MD is a healthcare provider registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 4300 W Main St Ste 21, Dothan, AL 36305-1058. The NPI number 1073508404 was assigned on September 12, 2005 and the record was last updated on March 3, 2021.

Dr. Carpenter lists a license in the registry: #17706 (AL) for Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Charles Jackie Carpenter Jr., MD?

The NPI number is 1073508404.

What is the phone number of Dr. Carpenter?

The phone number listed for the practice location is (334) 793-9564.

Where is Dr. Carpenter located?

4300 W Main St Ste 21, Dothan, AL 36305-1058.

What is the taxonomy code for Dr. Carpenter?

The primary taxonomy code is 208600000X – Surgery Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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