Provider Demographics
NPI:1194110346
Name:CARTER, ALYSEN M (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:ALYSEN
Middle Name:M
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:MS
Other - First Name:ALYSEN
Other - Middle Name:MARIE
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3889
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-3889
Mailing Address - Country:US
Mailing Address - Phone:276-386-3411
Mailing Address - Fax:
Practice Address - Street 1:390 KANE ST
Practice Address - Street 2:
Practice Address - City:GATE CITY
Practice Address - State:VA
Practice Address - Zip Code:24251-2753
Practice Address - Country:US
Practice Address - Phone:276-386-3411
Practice Address - Fax:276-386-3492
Is Sole Proprietor?:No
Enumeration Date:2015-04-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000058152207Q00000X
VA0101264409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine