Organization
CARNAHAN CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER E CARNAHAN D.O. (OWNER)
(662) 536-4646
Entity
Organization
Contact information
Practice address
7900 AIRWAYS BLVD BLDG A STE 6, SOUTHAVEN, MS 38671-4113
(662) 536-4646
(662) 536-4443
Mailing address
7900 AIRWAYS BLVD BLDG A STE 6, SOUTHAVEN, MS 38671
(662) 536-4646
(662) 536-4443
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16014
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174501449
DR. CARNAHAN NPI
—
01
—
1184602450
TAMMY FNP NPI
—
Enumeration date
04/06/2007
Last updated
07/03/2008
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