Individual
DR. PEARL CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2305 S HIGHWAY 65 BLDG A, MARSHALL, MO 65340-3702
(660) 886-7800
(660) 831-3306
Mailing address
2305 SOUTH 65 HIGHWAY, P O BOX 158, MARSHALL, MO 65340-3702
(660) 886-7431
(660) 886-9001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2007001548
MO
208M00000X
Hospitalist Physician
2007001548
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205472509
—
MO
01
—
38337016
BLUE CROSS BLUE SHIELD OF KC
MO
01
—
7713239
AETNA PIN
MO
01
—
795915
HEALTHLINK PIN
MO
01
—
H43884
MERCY HEALTH PLANS PIN
MO
Enumeration date
05/05/2006
Last updated
03/05/2024
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