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Organization
CARLYLE CARE CLINIC, PLLC
Active
Organization
CARLYLE CARE CLINIC, PLLC
Active
Other names
Prestige Hormone Health & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN WAGNER CARLYLE MD (AUTHORIZED OFFICIAL)
(479) 498-6700
Entity
Organization
Contact information
Practice address
509 E MILLSAP RD STE 107, FAYETTEVILLE, AR 72703-4862
(479) 480-7150
(479) 968-1673
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(800) 824-4094
(479) 968-1673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/03/2025
Last updated
01/27/2025
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