David R Carr, D.O.
Individual provider Active NPI Family Medicine Physician · Gary, WV
NPI 1245286137 · NPPES record last updated Feb 18, 2008
Key facts
- NPI
- 1245286137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 808 (WV)
- Practice address
- Route 103 Supply Street
Gary, WV 24836 - Phone
- (304) 448-2101
- Fax
- (304) 448-3217
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309 | WV | MD | Clinical Psychologist |
| 808 | WV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tug River Health Association, Inc | Past | Accepting new patients | |
| State of West Virginia Welch Emergency Hospital | Past | Accepting new patients | |
| Tug River Health Association, Inc | Past | Accepting new patients | |
| State of West Virginia Welch Community Hospital | Past | Accepting new patients | |
| Kelly Medical Services Corporation LLC | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 808 | WV | Yes |
Addresses
Primary practice location
Route 103 Supply Street
Gary, WV 24836
Mailing address
PO Box 100
Gary, WV 24836-0100
Phone (304) 448-2101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0040623000 | Medicaid | WV |
Other providers in Gary, WV
- John W Balaban
- Tamera Beth Ball
- Veronica Marie Brown
- Gail Carr
- Tara Cummings
- Sandra L Estep
- Sabrina Lynn Fowler
- Chyna Montaya Gray
All providers in Gary, WV · Family Medicine Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 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.