Individual
DR. LARRY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1040
(906) 483-1043
Mailing address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1040
(906) 483-1043
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MI43050397
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0829560001
MEDICARE DME
MI
01
—
0C16002
MEDICARE GROUP
MI
05
—
104362017
—
MI
01
—
LC050397
BLUECROSS STATE ID
MI
Enumeration date
05/19/2006
Last updated
11/23/2009
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