Individual provider · NPI-1
Dr. Benjamin Wagner Carlyle, M.D.
Internal Medicine · Farmington, AR
NPI number1184882383
StatusActive
Last updated in NPPESJan 24, 2025
Details
- NPI
- 1184882383
- Entity type
- Individual (NPI-1)
- Name
- Dr. Benjamin Wagner Carlyle
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 26, 2008
- Certification date
- Jan 24, 2025
- Last updated
- Jan 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | E-7051 | AR | Yes |
| 207Q00000X | Family Medicine | E-7051 | AR | |
| 208M00000X | Hospitalist | E-7051 | AR |
Practice location
3150 E Heritage Pkwy Ste 1Farmington, AR 72730-5529
Phone 479-400-1140 · Fax 479-400-1151
Mailing address
Po Box 497Augusta, AR 72006-0497
Phone 870-347-2534
Other practice locations
509 E Millsap Rd Ste 107
Fayetteville, AR 72703-4862
Fayetteville, AR 72703-4862
Phone 479-480-7150 · Fax 479-777-9881
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