Carroll, John Raymond
Carroll, John Raymond is an individual health care provider with primary practice located at 1032 S Cesar E Chavez Dr , Milwaukee WI 53204-2203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Carroll, John Raymond can be contacted via phone (414) 672-1353.Contact Information
Primary practice address
1032 S Cesar E Chavez Dr
Milwaukee WI 53204-2203
Phone: (414) 672-1353
Fax: (414) 672-4265
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 31103 | Wisconsin |
Profile Details
| NPI number | 1639142953 |
|---|---|
| LBN Legal business name | Carroll, John Raymond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1639142953 | NPPES |
| Wisconsin | Other | 4567737 | AETNA |
| Wisconsin | MEDICAID | 31609200 | AETNA |
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