Provider Demographics
NPI:1194920371
Name:BARTHOLOMEW, CARL D (DC, MD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:D
Last Name:BARTHOLOMEW
Suffix:
Gender:M
Credentials:DC, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SW RANGE AVE.
Mailing Address - Street 2:PO BOX 128
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32341-0128
Mailing Address - Country:US
Mailing Address - Phone:850-673-8338
Mailing Address - Fax:850-253-0069
Practice Address - Street 1:310 SW RANGE AVE.
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32341-0128
Practice Address - Country:US
Practice Address - Phone:850-673-8338
Practice Address - Fax:850-253-0069
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2180111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition