Healthcare Provider Details

I. General information

NPI: 1780180794
Provider Name (Legal Business Name): CARROLL ANNA TROY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 03/21/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8160 SEATON PL
MONTGOMERY AL
36116-7204
US

IV. Provider business mailing address

8160 SEATON PL
MONTGOMERY AL
36116-7204
US

V. Phone/Fax

Practice location:
  • Phone: 334-272-1799
  • Fax: 334-272-4876
Mailing address:
  • Phone: 334-272-1799
  • Fax: 334-272-4876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO.2950
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: