Provider Demographics
NPI:1841228475
Name:CARLYLE, MEGAN E (PA)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:E
Last Name:CARLYLE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3715 DAUPHIN ST STE 6A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1774
Mailing Address - Country:US
Mailing Address - Phone:251-414-1333
Mailing Address - Fax:251-414-3006
Practice Address - Street 1:3715 DAUPHIN ST STE 6A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1774
Practice Address - Country:US
Practice Address - Phone:251-414-1333
Practice Address - Fax:251-414-3006
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2019-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALPA375363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ30284Medicare UPIN
AL051555269CARMedicare ID - Type Unspecified