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Individual

MR. LARRY J CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA, APN

Contact information

Practice address
904 W TEMPLE AVE, EFFINGHAM, IL 62401-2178
(217) 342-1234
Mailing address
2630 E FORK DR, VANDALIA, IL 62471-3818
(618) 283-0233

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
IL
367500000X
Certified Registered Nurse Anesthetist
IL

Other

Enumeration date
08/29/2006
Last updated
09/11/2025
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