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1861545006 NPI number — WILLIAM E CARROLL DMD, MS

NPI Number: 1861545006
Health Care Provider/Practitioner: WILLIAM E CARROLL DMD, MS

Information about “1861545006” NPI (WILLIAM E CARROLL DMD, MS) exists in 1861545006 in HTML format HTML  |  1861545006 in plain Text format TXT  |  1861545006 in PDF (Portable Document Format) PDF  |  1861545006 in an XML format XML  formats.

NPI Number : 1861545006 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861545006",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARROLL",
    "FirstName": "WILLIAM",
    "MiddleName": "E",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DMD, MS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "110 HARDIN LANE",
    "SecondLineMailingAddress": "SUITE 2",
    "MailingAddressCityName": "SOMERSET",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "42503-3818",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "606-678-9664",
    "MailingAddressFaxNumber": "606-679-1457",
    "FirstLinePracticeLocationAddress": "110 HARDIN LANE",
    "SecondLinePracticeLocationAddress": "SUITE 2",
    "PracticeLocationAddressCityName": "SOMERSET",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "42503-3818",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "606-678-9664",
    "PracticeLocationAddressFaxNumber": "606-679-1457",
    "EnumerationDate": "01/19/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223P0300X",
        "TaxonomyName": "Periodontics",
        "LicenseNumber": "7497",
        "LicenseNumberStateCode": "KY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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