Individual
COLIN MICHAEL CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 897-9281
Mailing address
702 EXECUTIVE PARK, LOUISVILLE, KY 40207-4207
(502) 895-5405
(502) 894-9544
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
49643
TN
2085R0202X
Diagnostic Radiology Physician
49643
TN
2085R0202X
Diagnostic Radiology Physician
Primary
50836
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100505170
—
KY
Enumeration date
04/04/2012
Last updated
07/13/2021
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