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General NPI Number Information
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NPI Number | 1528130051
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Entity Type | Organization
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Legal Business Name | MCCARROLL PRIMARY CARE
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 198 N. MAIN ST
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City | ALMONT
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State | MI
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Zip | 48003
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Country | US
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Telephone | 810-798-6560
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 687
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City | ALMONT
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State | MI
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Zip | 48003
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Country | US
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Telephone | 810-798-6560
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Fax |
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Authorized Official
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Title or Position | OWNER-PHYSICIAN
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Name | BRIAN A MCCARROLL
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Credential | D.O.
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Telephone | 810-798-6560
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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 | BM007710
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License Number State | MI
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