Provider Demographics
NPI:1922054659
Name:CARLTON, LYNN NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:NORMAN
Last Name:CARLTON
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 1:5157 S CASTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-7708
Mailing Address - Country:US
Mailing Address - Phone:417-883-9805
Mailing Address - Fax:417-883-4829
Practice Address - Street 1:403 BURKARTH ROAD
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093
Practice Address - Country:US
Practice Address - Phone:660-747-2500
Practice Address - Fax:660-747-8455
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-36412085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR122964001Medicaid
ARE-3641OtherARKANSAS LICENSE NUMBER
AR122964001Medicaid
ARE-3641OtherARKANSAS LICENSE NUMBER