Carroll, Jonathan David
Carroll, Jonathan David is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Carroll, Jonathan David can be contacted via phone (601) 984-5452.Contact Information
Primary practice address
2500 N State St
Jackson MS 39216-4500
Phone: (601) 984-5452
Fax: (601) 815-3322
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD.203223 | Louisiana |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 24140 | Mississippi |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1548471956 |
|---|---|
| LBN Legal business name | Carroll, Jonathan David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2007 |
| Last updated | May 3rd, 2017 - about 7 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 | 1548471956 | NPPES |
| Mississippi | MEDICAID | 06027230 | |
| Mississippi | MEDICAID | 09978 | |
| Mississippi | Other | P01816798 |
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