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General NPI Number Information
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NPI Number | 1245423326
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Entity Type | Individual
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Provider Name | CHRISTINE CARROLL DO
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Gender | Female
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 1585 3RD ST
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City | FORT JOHNSON
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State | LA
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Zip | 71459-5102
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Country | US
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Telephone | 337-531-3701
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 844658
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City | DALLAS
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State | TX
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Zip | 75284-4658
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Country | US
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Telephone | 254-724-2111
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R9730
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R9730
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License Number State | TX
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