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General NPI Number Information
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NPI Number | 1457447815
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Entity Type | Individual
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Provider Name | ROBERT T CARSLEY MD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 230 TIMBER LN
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City | OXFORD
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State | MS
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Zip | 38655-5850
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Country | US
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Telephone | 662-236-3445
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Fax |
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Provider Business Mailing Address
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Address Line | 5480 GOODMAN RD SUITE 2
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-7902
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Country | US
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Telephone | 662-893-9877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00014651
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License Number State | WA
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