# CARROLL FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093091209
- **Authorized official:** DR. BARRY SCOTT CARROLL M.D. (PHYSICIAN)
- **Authorized official phone:** (501) 745-6100

## Contact information

- **Practice address:** 244 HIGHWAY 65 N, SUITE 1, CLINTON, AR 72031-6390
- **Practice address phone:** (501) 745-6100
- **Practice address fax:** (501) 745-6128
- **Mailing address:** PO BOX 808, CLINTON, AR 72031-0808
- **Mailing address phone:** (501) 745-6100
- **Mailing address fax:** (501) 745-6128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | C8231 | AR | Yes |

## Other

- **Enumeration date:** 11/01/2011
- **Last updated:** 11/01/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 124580001 | — | AR |
| 01 | — | 5J262 | BLUECROSS ARKANSAS | AR |
| 01 | — | 5J262B477 | MEDICARE PIN | AR |
| 01 | — | P00014280 | RAILROAD PIN | AR |