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1225060148

NPI Code Detail

MEDICARE: JAMES BRUCE CARROLL M.D.

MEDICARE: JAMES BRUCE 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
1	207Q00000X	Family Medicine Physician	31781	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	212036D	OTHER	NC	MEDICARE PIN
7	235013	OTHER	NC	MEDICARE PHYSICIAN
8	235013B	OTHER	NC	MEDICARE PHYSICIAN
10	411013849	OTHER	NC	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00513	OTHER	NC	BCBS
3	014MX	OTHER	NC	BCBS LABS
4	8907673	OTHER	NC	MEDCAID PHYSICIAN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	07673	OTHER	NC	BCBS PHYSICIAN
9	3400011	OTHER	NC	MEDCAID

General Provider Information

NPI Number	:	1225060148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BRUCE CARROLL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 27
Second Line	:
City	:	BAKERSVILLE
State	:	NC
Zip	:	28705-0027
Country	:	US
Telephone Number	:	828-688-2104
Fax Number	:	828-688-1334

Provider Business Practice Location Address
First Line	:	86 N MITCHELL AVE
Second Line	:
City	:	BAKERSVILLE
State	:	NC
Zip	:	28705-6502
Country	:	US
Telephone Number	:	828-688-2104
Fax Number	:	828-688-1334

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	11/28/2023

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Directions to “ JAMES BRUCE CARROLL M.D.” Practice Location

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