Individual
DR. DONALD PATSY DECARLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-5000
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
41222
TN
207P00000X
Emergency Medicine Physician
E-3157
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03183299
—
MS
05
—
3827202
—
TN
01
—
4132913
BLUE CROSS
TN
01
—
P00362728
RAILROAD MEDICARE
TN
Enumeration date
06/13/2006
Last updated
04/28/2020
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