=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639172760
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANNY K CARROLL M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2005
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2820 E ROCK HAVEN RD
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-4417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-380-7662
-----------------------------------------------------
Fax | 816-887-2192
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2820 E ROCK HAVEN RD
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-4417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-380-7662
-----------------------------------------------------
Fax | 816-887-2192
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | R1C81
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------