Provider Demographics
NPI:1104887850
Name:CARLTON, RICHARD ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:CARLTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N CENTER ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5057
Mailing Address - Country:US
Mailing Address - Phone:828-323-1100
Mailing Address - Fax:828-324-9189
Practice Address - Street 1:415 N CENTER ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5057
Practice Address - Country:US
Practice Address - Phone:828-323-1100
Practice Address - Fax:828-324-9189
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33626208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8921144Medicaid
NC3760384OtherCAROLINA CARE PLAN (PHP)
NCE07605Medicare UPIN
NC213866BMedicare ID - Type Unspecified