MEDICARE: KAREN CARNEY DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	179678	MS

General Provider Information

NPI Number	:	1942213848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN CARNEY DDS PA

Provider Business Mailing Address
First Line	:	2189 HENRY HILL DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39204-2125
Country	:	US
Telephone Number	:	601-922-3643
Fax Number	:	601-922-3645

Provider Business Practice Location Address
First Line	:	2189 HENRY HILL DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39204-2125
Country	:	US
Telephone Number	:	601-922-3643
Fax Number	:	601-922-3645

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. KAREN CARNEY
Credential	:	DDS
Telephone Number	:	601-922-3643

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	08/22/2020

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