Carroll, David Roland
Carroll, David Roland is an sole proprietor health care provider with primary practice located at 971 Lakeland Dr Suite 656, Jackson MS 39216-4643. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Carroll, David Roland can be contacted via phone (601) 366-6606.Contact Information
Primary practice address
971 Lakeland Dr Suite 656
Jackson MS 39216-4643
Phone: (601) 366-6606
Fax: (601) 366-6647
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 16117 | Mississippi |
Profile Details
| NPI number | 1679562730 |
|---|---|
| LBN Legal business name | Carroll, David Roland |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 20th, 2005 |
| Last updated | Nov 18th, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679562730 | NPPES |
| Mississippi | MEDICAID | 00120078 |
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