Provider Demographics
NPI:1700975984
Name:TINGLE, CAROLYN FRANCES (M D)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:FRANCES
Last Name:TINGLE
Suffix:
Gender:F
Credentials:M D
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:VARDAMAN
Other - Last Name:TINGLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:M D
Mailing Address - Street 1:PO BOX 157A
Mailing Address - Street 2:
Mailing Address - City:WHITFIELD
Mailing Address - State:MS
Mailing Address - Zip Code:39193-0157
Mailing Address - Country:US
Mailing Address - Phone:601-351-8000
Mailing Address - Fax:601-351-8301
Practice Address - Street 1:3550 HIGHWAY 468 WEST
Practice Address - Street 2:
Practice Address - City:WHITFIELD
Practice Address - State:MS
Practice Address - Zip Code:39193-0157
Practice Address - Country:US
Practice Address - Phone:601-351-8000
Practice Address - Fax:601-351-8301
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS121622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00116567Medicaid
MS260000232Medicare ID - Type Unspecified