Individual
DR. THEODORE CLYDE CARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12251 N 32ND ST, PHOENIX, AZ 85032
(602) 971-0950
Mailing address
12251 N. 32ND ST, PHOENIX, AZ 85032
(602) 971-0950
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20564
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
20564
AZ
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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