Provider Demographics
NPI:1710145701
Name:CARPENTER, DYLAN PRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:PRICE
Last Name:CARPENTER
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 1:501 VIRGINIA DR STE C
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7317
Mailing Address - Country:US
Mailing Address - Phone:870-793-2371
Mailing Address - Fax:
Practice Address - Street 1:501 VIRGINIA DR STE C
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7317
Practice Address - Country:US
Practice Address - Phone:870-793-2371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7867207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery