Carroll, Lee Gordon

Carroll, Lee Gordon is an individual health care provider with primary practice located at 6701 N Charles St , Towson MD 21204-6808. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Carroll, Lee Gordon can be contacted via phone (410) 296-4616.

Contact Information

Primary practice address
6701 N Charles St Towson MD 21204-6808
Phone: (410) 296-4616
Fax: (410) 337-5068
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R144380 Maryland

Profile Details

NPI number 1942490610
LBN Legal business name Carroll, Lee Gordon
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2007
Last updated Oct 25th, 2007 - about 17 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 1942490610 NPPES
Other R144380 STATE LICENCE

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