Carroll, Gregory S

Carroll, Gregory S is an individual health care provider with primary practice located at 10250 Sw Greenburg Rd 4 Lincoln Center, Suite 125, Tigard OR 97223-5470. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Carroll, Gregory S can be contacted via phone (503) 719-6783.

Contact Information

Primary practice address
10250 Sw Greenburg Rd 4 Lincoln Center, Suite 125 Tigard OR 97223-5470
Phone: (503) 719-6783
Fax: (971) 327-6734
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD26081 Oregon
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD26081 Oregon

Profile Details

NPI number 1588688014
LBN Legal business name Carroll, Gregory S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Jan 21st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588688014 NPPES
Oregon MEDICAID 005705

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