Provider Demographics
NPI:1952356818
Name:CARLTON, SONI S (MD)
Entity Type:Individual
Prefix:DR
First Name:SONI
Middle Name:S
Last Name:CARLTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 OAK LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2513
Mailing Address - Country:US
Mailing Address - Phone:434-847-6132
Mailing Address - Fax:434-845-4870
Practice Address - Street 1:1330 OAK LN
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2513
Practice Address - Country:US
Practice Address - Phone:434-847-6132
Practice Address - Fax:434-845-4870
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01011232721207N00000X, 207ND0900X, 207NI0002X, 207NP0225X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3915571OtherCIGNA
VA277568OtherANTHEM
VA5902339Medicaid
VA310023OtherSOUTHERN HEALTH
VAH61841Medicare UPIN