Individual
DR. JEFFREY A CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
037164
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00587067A
—
GA
01
—
0479686
AETNA HMO
GA
01
—
05200
COVENTRY PPO
GA
01
—
0891170
UHC
GA
01
—
1078920004
DME
GA
01
—
180025244
RR MEDICARE
GA
01
—
4486398
AETNA
GA
01
—
507240
BCBS
GA
01
—
9856
COVENTRY HMO
GA
Enumeration date
06/30/2005
Last updated
03/08/2021
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