Cantrell, Carol R

Cantrell, Carol R is an sole proprietor health care provider with primary practice located at 2304 Memorial Blvd , Springfield TN 37172-3929. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Cantrell, Carol R can be contacted via phone (615) 384-8133.

Contact Information

Primary practice address
2304 Memorial Blvd Springfield TN 37172-3929
Fax: (615) 384-8199
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD018063 Tennessee

Profile Details

NPI number 1417996117
LBN Legal business name Cantrell, Carol R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2006
Last updated Aug 8th, 2017 - about 9 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 1417996117 NPPES
Tennessee MEDICAID 3037764
Tennessee Other 3136613

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