Roger L Carter, MD
Individual provider Active NPI Surgery Physician · Watertown, SD
NPI 1225017809 · NPPES record last updated May 8, 2008
Key facts
- NPI
- 1225017809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 1729 (SD)
- Practice address
- 901 4TH St NW
Watertown, SD 57201-1565 - Phone
- (605) 886-8471
- Fax
- (605) 886-9317
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1729 | SD | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Lakes Health Care System Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 1729 | SD | Yes |
Addresses
Primary practice location
901 4TH St NW
Watertown, SD 57201-1565
Mailing address
PO Box 290
Watertown, SD 57201-0290
Phone (605) 886-8471
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7300952 | Medicaid | SD |
Other providers in Watertown, SD
- Vickie Lynn Burchatz
- Jennifer Lee Byer
- Care Anywhere
- David T. Carlson
- Amanda Renee Carter-Boomsma
- Christine Marie Cass
- Catholic Family Services
- Cedar Lakes Therapy, LLC
- Chad D. Beynon, O.D., P.C.
- Alan R Christensen
All providers in Watertown, SD · Surgery Physician in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.