DR. LARRY W CARRUTH M.D. NPI 1306835483

NPI Information

  • NPI: 1306835483
  • Provider Name: DR. LARRY W CARRUTH, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 96 PHYSICIANS DR
    96 PHYSICIANS DRIVE
    JACKSON, TN
    ZIP 38305
  • Phone: (731) 664-8771

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NPI Details

DR. Larry W Carruth, M.D. is a specialist in Jackson, TN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Larry W Carruth, M.D. NPI is 1306835483. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

96 PHYSICIANS DR
96 PHYSICIANS DRIVE
JACKSON, TN
ZIP 38305-070
Phone: (731) 664-8771
Fax: (731) 660-7050

The enumeration date for this NPI number is 10/20/2005 and was last updated on 4/6/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistMD009363TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13170825MEDICARE ID-TYPE UNSPECIFIEDTENNESSEEMEDICARE
23170825MEDICAIDTENNESSEE
3000050023OTHERTENNESSEEBCBS OF TN
4621582944OTHERTENNESSEETAX ID -COMMERCIAL INS
5B03427MEDICARE UPINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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