Individual
IAN L CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 502-1900
(918) 494-6303
Mailing address
6600 S YALE AVE STE 1200, TULSA, OK 74136-3361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27379
OK
208M00000X
Hospitalist Physician
Primary
27379
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200264470A
—
OK
05
—
MD3207
—
AK
Enumeration date
05/25/2006
Last updated
10/16/2024
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