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Individual

ROBERT L CAROLLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3850 S NATIONAL AVE, SUITE 600, SPRINGFIELD, MO 65807-5287
(417) 882-4880
(417) 882-7843
Mailing address
3850 S NATIONAL AVE, SUITE 600, SPRINGFIELD, MO 65807-5287

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
R4802
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0628420001
DMERC
MO
01
17951
ANTHEM BCBS
MO
01
3640001
UNITED HEALTHCARE
MO
Enumeration date
03/09/2006
Last updated
11/29/2007
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