Individual
ANNETTE CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
51 N DUNLAP ST, MEMPHIS, TN 38105-4625
(901) 287-7337
Mailing address
850 POPLAR AVE BLDG 2, MEMPHIS, TN 38105-4607
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
E-10471
AR
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
61070
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08808809
—
MS
05
—
220713001
—
AR
05
—
Q043210
—
TN
Enumeration date
04/10/2014
Last updated
09/17/2020
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