| Stacey B. Carlton, Md, Pc | |
|
229 Interstate Dr Ste 105 Crossville TN 38555-2704 | |
| (931) 981-9809 | |
| (931) 456-2844 |
| Full Name | Stacey B. Carlton, Md, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 229 Interstate Dr Ste 105, Crossville, Tennessee |
| Authorized Official Name and Position | Joey Todd Carlton (ADMINISTRATOR) |
| Authorized Official Contact | 9319819809 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey B. Carlton, Md, Pc 229 Interstate Dr Ste 105 Crossville TN 38555-2704 Ph: (931) 981-9809 | Stacey B. Carlton, Md, Pc 229 Interstate Dr Ste 105 Crossville TN 38555-2704 Ph: (931) 981-9809 |
| NPI Number | 1528248002 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 09/02/2025 |
| Medicare PECOS PAC ID | 5193815298 |
|---|---|
| Medicare Enrollment ID | O20071212000797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528248002 | NPI | - | NPPES |
| 3849058 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25887 (Tennessee) | Primary |
| Provider Name | Stacey B Carlton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619976941 PECOS PAC ID: 5395705552 Enrollment ID: I20050927001556 |
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