Carroll, John T

Carroll, John T is an individual health care provider with primary practice located at 455 Boston Post Rd Ste 8 , Old Saybrook CT 06475-1554. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot Surgery is his primary health care specialty. Carroll, John T can be contacted via phone (860) 510-0502.

Contact Information

Primary practice address
455 Boston Post Rd Ste 8 Old Saybrook CT 06475-1554
Phone: (860) 510-0502
Fax: (860) 510-0551
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X 000027 Connecticut
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 000027 Connecticut

Profile Details

NPI number 1508946054
LBN Legal business name Carroll, John T
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated May 19th, 2016 - about 8 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 1508946054 NPPES
Connecticut MEDICAID 004006276

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