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General NPI Number Information
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NPI Number | 1275719445
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Entity Type | Individual
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Provider Name | PATRICK DOUGLAS CARROLL M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 544 S 400 E
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City | ST GEORGE
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State | UT
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Zip | 84770-3705
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Country | US
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Telephone | 435-688-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 544 S 400 E
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City | ST GEORGE
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State | UT
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Zip | 84770-3705
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Country | US
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Telephone | 435-688-2000
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 35.088644
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 7590021-1205
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License Number State | UT
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