Individual
KATIE JANETTE CARILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
1701 CLUB MANOR DR STE 2B, MAUMELLE, AR 72113-7401
(501) 843-4555
(501) 743-1550
Mailing address
11001 EXECUTIVE CENTER DR STE 200, LITTLE ROCK, AR 72211-4393
(501) 851-7402
(501) 851-4753
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA468
AR
Other
Enumeration date
04/27/2012
Last updated
09/20/2024
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