Individual
DR. CHRISTOPHER PATRICK CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 PRUDENTIAL DR STE 304, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME95430
FL
208M00000X
Hospitalist Physician
Primary
ME95430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009366300
—
FL
05
—
467041573A
—
GA
01
—
P00804053
MEDICARE RR
FL
Enumeration date
09/02/2006
Last updated
06/07/2024
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