Carroll, Matthew L.
Carroll, Matthew L. is an individual health care provider with primary practice located at 1400 S Germantown Rd , Germantown TN 38138-2205. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Carroll, Matthew L. can be contacted via phone (901) 759-3100.Contact Information
Primary practice address
1400 S Germantown Rd
Germantown TN 38138-2205
Phone: (901) 759-3100
Fax: (901) 759-3196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | MPA.1778.TL | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA180137 | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA00386 | Mississippi |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 3336 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 3366 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 200682 | Louisiana |
Profile Details
| NPI number | 1346595014 |
|---|---|
| LBN Legal business name | Carroll, Matthew L. |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2012 |
| Last updated | Oct 7th, 2022 - 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 | 1346595014 | NPPES |
| Tennessee | MEDICAID | Q031131 | |
| Tennessee | MEDICAID | 07004261 | |
| Tennessee | Other | 1102675 | |
| Tennessee | MEDICAID | 2351991 | |
| Tennessee | Other | MPA.1778.TL |
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