Provider Demographics
NPI:1063571990
Name:CARR, JAMES A
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:CARR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476
Mailing Address - Country:US
Mailing Address - Phone:707-996-5902
Mailing Address - Fax:707-996-5902
Practice Address - Street 1:273 MANUELLA LANE
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476
Practice Address - Country:US
Practice Address - Phone:707-996-5902
Practice Address - Fax:707-996-5902
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor