Individual
NEIL J CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3950 17TH ST, BAKER CITY, OR 97814-1300
(541) 523-1001
(541) 523-1152
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD167452
OR
Other
Enumeration date
04/11/2011
Last updated
09/26/2014
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