Provider Demographics
NPI:1629651955
Name:CARMICAL MEDICAL PLLC
Entity Type:Organization
Organization Name:CARMICAL MEDICAL PLLC
Other - Org Name:WOODSIDE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMICAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-224-4411
Mailing Address - Street 1:940 OLD WARREN ROAD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655
Mailing Address - Country:US
Mailing Address - Phone:870-224-4411
Mailing Address - Fax:870-224-0925
Practice Address - Street 1:940 OLD WARREN ROAD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655
Practice Address - Country:US
Practice Address - Phone:870-224-4411
Practice Address - Fax:870-224-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty