Individual
CARLTON RALPH DANIEL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
971 LAKELAND DR, 659, JACKSON, MS 39216-4609
(601) 362-8514
(601) 366-7621
Mailing address
971 LAKELAND DR, 659, JACKSON, MS 39216-4609
(601) 362-8514
(601) 366-7621
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
7976
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00019627
—
MS
Enumeration date
07/12/2006
Last updated
07/08/2007
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