Individual
WILLIAM THOMAS CARROLL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACNPC-AG
Contact information
Practice address
601 DALLAS HWY, VILLA RICA, GA 30180-1202
(770) 812-3000
Mailing address
601 DALLAS HWY, VILLA RICA, GA 30180-1202
(770) 812-3000
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
234604
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
234604
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
234604
RN
GA
Enumeration date
04/12/2021
Last updated
07/13/2023
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