Carroll, Ty B

Carroll, Ty B is an individual health care provider with primary practice located at W129N7055 Northfield Dr Division Of Endocrinology, Menomonee Falls WI 53051-0538. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is his primary health care specialty. Carroll, Ty B can be contacted via phone (262) 253-7155.

Contact Information

Primary practice address
W129N7055 Northfield Dr Division Of Endocrinology Menomonee Falls WI 53051-0538
Phone: (262) 253-7155
Fax: (262) 253-7140
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 46886 Wisconsin
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 46886 Wisconsin

Profile Details

NPI number 1558312942
LBN Legal business name Carroll, Ty B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Feb 14th, 2013 - about 12 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 1558312942 NPPES
Other 007806261E HUMANA
MEDICAID 1558312942 HUMANA

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