Individual
DR. DANIEL D CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2202 N JOHN B DENNIS HWY STE 204, KINGSPORT, TN 37660-5904
(423) 224-3300
(423) 378-5324
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101047148
VA
207Q00000X
Family Medicine Physician
Primary
19714
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005609895
—
VA
05
—
1518004
—
TN
05
—
3047223
—
TN
Enumeration date
02/24/2006
Last updated
11/01/2018
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