Davis, Carrie Lynn

Davis, Carrie Lynn is an individual health care provider with primary practice located at 1200 S Rogers St , Bloomington IN 47403-4792. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Davis, Carrie Lynn can be contacted via phone (812) 339-6434.

Contact Information

Primary practice address
1200 S Rogers St Bloomington IN 47403-4792
Fax: (812) 331-0196
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 01064872A Indiana
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 01064872A Indiana

Profile Details

NPI number 1801063128
LBN Legal business name Davis, Carrie Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2008
Last updated Mar 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801063128 NPPES
Indiana MEDICAID 200903360A

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