Provider Demographics
NPI:1407943442
Name:CARNEY, LEE ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ANTHONY
Last Name:CARNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 6525
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39441
Mailing Address - Country:US
Mailing Address - Phone:601-649-5421
Mailing Address - Fax:601-426-3690
Practice Address - Street 1:1008 N 15TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-2656
Practice Address - Country:US
Practice Address - Phone:601-649-5421
Practice Address - Fax:601-426-3690
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20672207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology