Carroll, Jeffrey

Carroll, Jeffrey is an individual health care provider with primary practice located at 225 Memorial Dr Ste 1400 , Berlin WI 54923-1243. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Carroll, Jeffrey can be contacted via phone (920) 361-5760.

Contact Information

Primary practice address
225 Memorial Dr Ste 1400 Berlin WI 54923-1243
Phone: (920) 361-5760
Fax: (920) 361-5766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 22313-020 Wisconsin
Allopathic & Osteopathic Physicians / Surgery 208600000X 22313-020 Wisconsin

Profile Details

NPI number 1255332144
LBN Legal business name Carroll, Jeffrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Dec 24th, 2009 - 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 1255332144 NPPES
Wisconsin MEDICAID 30398700

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