Carroll, Kenneth

Carroll, Kenneth is an individual health care provider with primary practice located at 461 Cook St Suite B, Royston GA 30662-4003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Carroll, Kenneth can be contacted via phone (706) 245-1877.

Contact Information

Primary practice address
461 Cook St Suite B Royston GA 30662-4003
Phone: (706) 245-1877
Fax: (706) 245-1433
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 018369 Georgia

Profile Details

NPI number 1205990330
LBN Legal business name Carroll, Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2006
Last updated Jul 8th, 2007 - about 18 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 1205990330 NPPES
Georgia Other 4505967 AETNA PROV NUMBER
Georgia Other 975810 AETNA PROV NUMBER

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