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NPI Code Detail

MEDICARE: DR. TY B CARROLL MD

MEDICARE: DR. TY B CARROLL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician46886WI
2207RE0101XEndocrinology, Diabetes & Metabolism Physician46886WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1007806261EOTHERHUMANA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558312942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TY B CARROLL MD
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4621 EASTPARK BLVD
Second Line :
City : MADISON
State : WI
Zip : 53718-2000
Country : US
Telephone Number : 608-916-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 12/02/2025

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