Katie J. Carillon P.A.C.
Medical Physician Assistant in Maumelle, AR(View on Map)
Full Name
Katie Janette Carillon P.A.C.
NPI Number
1649538679
NPI Type
Individual Provider
Gender
Female
Enumeration Date
04/27/2012
Specialties
(Taxonomies)Licenses
State
Arkansas
License Number
PA468
Contact
Information
Purpose
Mailing
Location
Address
11001 EXECUTIVE CENTER DR STE 200
1701 CLUB MANOR DR STE 2B
City
Little Rock
Maumelle
State
AR
AR
Postal Code
72211-4393
72113-7401
Country
US
US
Telephone Number
(501) 851-7402
(501) 843-4555
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/20/2024