Individual
MR. CARROLL EVERETT ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1610 TAZEWELL RD, STE 301, TAZEWELL, TN 37879-3600
(423) 626-4288
(423) 626-1101
Mailing address
PO BOX 1679, NEW TAZEWELL, TN 37825-1679
(423) 626-4288
(423) 626-1101
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7511
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528259
—
TN
Enumeration date
08/02/2005
Last updated
01/02/2013
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