| Doctor Name: | MR. CHARLES RICHARD CARLETON |
| NPI Number: | 1457357469 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSN, FNP-C |
| License Number: | A-099327 |
| Business Practice Address: | 510 Stoner Ave Shreveport, LA - 711014123 |
| Business Phone Number: | 3182218411 |
| Business Fax Number: | 3184295710 |
| Mailing Address: | 9075 Summer Tree Cir, GREENWOOD |
| State: | LA |
| Postal Code: | 710333051 |
| Phone Number: | 3189386743 |
| Fax Number: | |
| NPI Enumeration Date: | 06/23/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A-099327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |