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General NPI Number Information
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NPI Number | 1831029834
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Entity Type | Individual
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Provider Name | WILLIAM AUSTIN CARMACK
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Gender |
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Dates
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Enumeration Date | 05/21/2026
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Last Update Date | 05/21/2026
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Provider Practice Location Address
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Address Line | 423 HIGHWAY 365
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City | TISHOMINGO
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State | MS
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Zip | 38873-9341
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Country | US
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Telephone | 662-660-6994
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Fax |
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Provider Business Mailing Address
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Address Line | 423 HIGHWAY 365
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City | TISHOMINGO
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State | MS
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Zip | 38873-9341
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Country | US
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Telephone |
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 926127
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License Number State | MS
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