Individual
DAVID CARROLL MOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9360 BRINKMAN RD, CARLYLE, IL 62231-3263
(618) 594-2329
Mailing address
9360 BRINKMAN RD, CARLYLE, IL 62231-3263
(618) 594-2329
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-093809
IL
Other
Enumeration date
07/15/2006
Last updated
02/16/2012
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