MEDICARE: CARLYLE CARE CLINIC, PLLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1508675612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLYLE CARE CLINIC, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 9178
Second Line	:
City	:	RUSSELLVILLE
State	:	AR
Zip	:	72811-9178
Country	:	US
Telephone Number	:	800-824-4094
Fax Number	:	479-968-1673

Provider Business Practice Location Address
First Line	:	509 E MILLSAP RD STE 107
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-4862
Country	:	US
Telephone Number	:	479-480-7150
Fax Number	:	479-968-1673

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	BENJAMIN WAGNER CARLYLE
Credential	:	MD
Telephone Number	:	479-498-6700

Provider Enumeration Date	:	01/03/2025
Last Update Date	:	01/27/2025

Similar Medicare Providers

1295913416 — TOTAL RENAL CARE INC
Practice Location Address:

509 E MILLSAP RD , STE 111
FAYETTEVILLE, AR
72703-4862

Practice Phone: 479-443-6688
Practice Fax: 479-527-9917

1295032407 — INTERVENTIONAL PAIN SPECIALISTS OF NWA, PLLC
Practice Location Address:

509 E MILLSAP RD STE 109
FAYETTEVILLE, AR
72703-4862

Practice Phone: 479-595-8192
Practice Fax: 479-442-1748

1902239486 — AUSTIN ALAN KRAMER DPM
Practice Location Address:

509 E MILLSAP RD STE 101
FAYETTEVILLE, AR
72703-4862

Practice Phone: 479-587-0171
Practice Fax: 479-587-0885

1942822465 — KLAIRE HOWARD
Practice Location Address:

509 E MILLSAP RD STE 105
FAYETTEVILLE, AR
72703-4862

Practice Phone: 479-561-7600
Practice Fax:

1710564455 — MR. SCOTT MASHBURN
Practice Location Address:

509 E MILLSAP RD STE 109
FAYETTEVILLE, AR
72703-4862

Practice Phone: 479-935-2300
Practice Fax:

1780380956 — FAYETTEVILLE GROUP HEALTH, LLC
Practice Location Address:

509 E MILLSAP RD STE 107
FAYETTEVILLE, AR
72703-4862

Practice Phone: 281-429-8526
Practice Fax:

Directions to “CARLYLE CARE CLINIC, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.