Basic Information
| Provider Information | |||||||||
| NPI: | 1356617013 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARNES | ||||||||
| FirstName: | BETHANY | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 740 COOL SPRINGS BLVD | ||||||||
| Address2: | STE 220 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370676448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6155504030 | ||||||||
| FaxNumber: | 6155504035 | ||||||||
| Practice Location | |||||||||
| Address1: | 1370 GATEWAY BLVD | ||||||||
| Address2: | STE 110 | ||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371292589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158909008 | ||||||||
| FaxNumber: | 6158900193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2012 | ||||||||
| LastUpdateDate: | 07/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | 52117 | TN | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.