Healthcare Provider Details

I. General information

NPI: 1346238359
Provider Name (Legal Business Name): CARLA MITCHELL ARMSTRONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 HOSPITAL DR
TYLERTOWN MS
39667-2021
US

IV. Provider business mailing address

155 HOSPITAL DR P O BOX 424
TYLERTOWN MS
39667-2021
US

V. Phone/Fax

Practice location:
  • Phone: 601-876-5337
  • Fax: 601-876-5190
Mailing address:
  • Phone: 601-876-5337
  • Fax: 601-876-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number14419
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: