Individual
JUSTIN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
376 W 10TH AVE, 760 PRIOR HALL,, COLUMBUS, OH 43210-1280
(614) 293-3551
Mailing address
601 S 8TH ST, GRIFFIN, GA 30224-4213
(770) 228-2721
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
84208
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2015
Last updated
10/21/2019
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