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NPI 1396064531

NPI 1396064531 : CARROLL HOSPITAL ASSOCIATES, PLLC : HUNTINGDON, TN

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General NPI Number Information
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    NPI Number           |    1396064531
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    Entity Type          |    Organization 
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    Legal Business Name  |    CARROLL HOSPITAL ASSOCIATES, PLLC 
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Dates
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    Enumeration Date     |    05/27/2010
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    Last Update Date     |    05/27/2010
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Provider Practice Location Address
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    Address Line         |    631 R. B. WILSON DRIVE 
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    City                 |    HUNTINGDON
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    State                |    TN
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    Zip                  |    38344
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    Country              |    US
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    Telephone            |    731-986-2933
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    Fax                  |    731-986-2938
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1051 
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    City                 |    HUNTINGDON
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    State                |    TN
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    Zip                  |    38344-1051
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    Country              |    US
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    Telephone            |    731-986-2933
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    Fax                  |    731-986-2938
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Authorized Official
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    Title or Position    |    MD
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    Name                 |    DR. THOMAS PAUL EVANS 
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    Credential           |    MD
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    Telephone            |    731-986-2933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    31824
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    License Number State |    TN
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