Individual
DR. TRENT JOSEPH CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2254 OLYMPIC ST, SPRINGFIELD, OH 45503-2737
(937) 399-8287
Mailing address
2254 OLYMPIC ST, SPRINGFIELD, OH 45503-2737
(937) 399-8287
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35055123
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0668175
MEDICAID
OH
Enumeration date
07/12/2005
Last updated
02/15/2008
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