Individual
LOREN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
346 SHADOW RIDGE DR, JACKSON, TN 38305-8507
(731) 345-0263
Mailing address
346 SHADOW RIDGE DR, JACKSON, TN 38305-8507
(731) 345-0263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
51998
TN
Other
Enumeration date
03/18/2013
Last updated
06/23/2016
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