Individual
NELS DAVIS CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
227 W JANSS RD STE 340, THOUSAND OAKS, CA 91360-1879
(805) 852-9100
Mailing address
PO BOX 743111, ATLANTA, GA 30374-3111
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A192800
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD61172512
WA
Other
Enumeration date
05/01/2015
Last updated
02/22/2024
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