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General NPI Number Information
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NPI Number | 1528248002
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Entity Type | Organization
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Legal Business Name | STACEY B. CARLTON, MD, PC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 229 INTERSTATE DR STE 105
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City | CROSSVILLE
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State | TN
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Zip | 38555-2704
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Country | US
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Telephone | 931-981-9809
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Fax | 931-456-2844
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Provider Business Mailing Address
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Address Line | 229 INTERSTATE DR STE 105
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City | CROSSVILLE
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State | TN
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Zip | 38555-2704
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Country | US
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Telephone | 931-981-9809
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Fax | 931-456-2844
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOEY TODD CARLTON
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Credential | BBA, EMT-P
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Telephone | 931-981-9809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25887
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License Number State | TN
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