1134631005 NPI number — DR. RUEBEN LAWRENCE CARTER JR. DC

Table of content: DR. RUEBEN LAWRENCE CARTER JR. DC (NPI 1134631005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134631005 NPI number — DR. RUEBEN LAWRENCE CARTER JR. DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER
Provider First Name:
RUEBEN
Provider Middle Name:
LAWRENCE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134631005
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
549 W MARLIN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TERRYTOWN
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70056-2851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3308 TULANE AVE STE 303
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70119-7161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-233-2083
Provider Business Practice Location Address Fax Number:
504-605-2217
Provider Enumeration Date:
10/31/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1803 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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