Provider Demographics
NPI:1780941724
Name:CARNELL, ANTHONY QUINTAIN (DO)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:QUINTAIN
Last Name:CARNELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4631 RIDGE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1028
Mailing Address - Country:US
Mailing Address - Phone:513-631-1268
Mailing Address - Fax:513-366-4121
Practice Address - Street 1:4631 RIDGE AVE STE B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209
Practice Address - Country:US
Practice Address - Phone:513-631-1268
Practice Address - Fax:513-366-4121
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8453207Q00000X
OH34.013765207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine