Provider Demographics
NPI:1447519343
Name:MEHAFFEY, CAROLYN ELAINE (MD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ELAINE
Last Name:MEHAFFEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:ELAINE
Other - Last Name:REDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:655 DAVE WARD DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-7145
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:655 DAVE WARD DR STE 103
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-7145
Practice Address - Country:US
Practice Address - Phone:501-209-4040
Practice Address - Fax:501-205-1776
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-98532084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology