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General NPI Number Information
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NPI Number | 1013919380
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Entity Type | Individual
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Provider Name | ROBERT JOHN CARROLL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 850 W BARAGA AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-4550
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Country | US
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Telephone | 906-449-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 HENNESSY BLVD FIRST FLOOR
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City | BATON ROUGE
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State | LA
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Zip | 70808-4375
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Country | US
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Telephone | 225-765-4050
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Fax | 225-765-4046
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 026319
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301102218
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 4301102218
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License Number State | MI
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