Individual
DR. JOHN T CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
455 BOSTON POST RD STE 8, OLD SAYBROOK, CT 06475-1554
(860) 510-0502
(860) 510-0551
Mailing address
196 PARKWAY S 302, WATERFORD, CT 06385-1234
(860) 447-1488
(860) 447-1489
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
000027
CT
213ES0131X
Foot Surgery Podiatrist
Primary
000027
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004006276
—
CT
Enumeration date
10/17/2006
Last updated
05/19/2016
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