Jared Carlton

Individual provider Active NPI General Practice Physician · Fallon, NV

NPI 1336726835 · NPPES record last updated Jun 21, 2023

Key facts

NPI
1336726835
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
0101276734 (VA)
Practice address
Nmrtu Fallon
4755 Pasture Rd
Fallon, NV 89406
Phone
(775) 426-3120
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0101276734VAMDGeneral Practice Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 0101276734 VA
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 0101276734 VA Yes

Addresses

Primary practice location

Nmrtu Fallon
4755 Pasture Rd
Fallon, NV 89406

Mailing address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Other providers in Fallon, NV

All providers in Fallon, NV · General Practice Physician in Nevada

Sources for this page

Verify at the official NPI Registry.