Healthcare Provider Details

I. General information

NPI: 1427018514
Provider Name (Legal Business Name): PAUL F CARROLL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 N POINTE BLVD
LANCASTER PA
17601-4132
US

IV. Provider business mailing address

170 N POINTE BLVD
LANCASTER PA
17601-4132
US

V. Phone/Fax

Practice location:
  • Phone: 717-299-4871
  • Fax: 717-391-2494
Mailing address:
  • Phone: 717-299-4871
  • Fax: 717-391-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD068134L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD068134L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberMD068134L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: