Carroll Atkins Palmore Jr., DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2028-83 Issued in MS

Practice address

606 Fisher St
81MDG/SGD
Keesler Afb, MS 39534-2513

Phone

(228) 377-2964

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235125097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 BREEZY HILL LN",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395648510",
            "telephone_number": "228-875-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 FISHER ST",
            "address_2": "81MDG/SGD",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342513",
            "telephone_number": "228-377-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMORE",
        "first_name": "CARROLL",
        "middle_name": "ATKINS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MS",
            "license": "2028-83",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Nicholson, LCSW
• Brent Eugene Nikolaus, D.D.S.
• Wendy Faviola Oliver, MSW,LCSW-A
• Verity Oltjenbruns, DO
• Optical Center
• Breanne Parets
• Robert C. Perryman, PHYSICIAN ASSISTANT
• Julie Petsche
• Dat Van Phan, DO
• Sarah Elizabeth Poirier, MD

• Oral and Maxillofacial Surgery (Dentist) in Keesler Afb, MS
• Providers in Keesler Afb, MS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.