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NPI Code Detail

MEDICARE: DR. BELLA STERLING CARROLL M.D.

MEDICARE: DR. BELLA STERLING CARROLL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianM0032TX
2207Q00000XFamily Medicine Physician18611OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
118611OTHEROKMEDICAL LICENSE
2M0032OTHERTXTX MEDICAL BOARD

General Provider Information

NPI Number : 1104154665
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BELLA STERLING CARROLL M.D.
Provider Business Mailing Address
First Line : 6201 N SANTA FE AVE STE 2010
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-7532
Country : US
Telephone Number : 405-272-5555
Fax Number : 405-272-5517
Provider Business Practice Location Address
First Line : 6201 N SANTA FE AVE STE 2010
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-7532
Country : US
Telephone Number : 405-272-5555
Fax Number : 405-272-5517
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2009
Last Update Date : 11/10/2020

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