Mallett, Carl G

Mallett, Carl G is an sole proprietor health care provider with primary practice located at 1128 Hidden Oak Ln , Lake Charles LA 70605-7123. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Mallett, Carl G can be contacted via phone (337) 478-1085.

Contact Information

Primary practice address
1128 Hidden Oak Ln Lake Charles LA 70605-7123
Phone: (337) 478-1085
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 03828 Louisiana

Profile Details

NPI number 1104806124
LBN Legal business name Mallett, Carl G
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 17th, 2006
Last updated Sep 22nd, 2010 - about 14 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 1104806124 NPPES
Louisiana Other P00140225 RAILROAD MEDICARE PIN
Louisiana MEDICAID 1115096 RAILROAD MEDICARE PIN

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