Individual
JOHN R MCCARROLL
Active
Individual
JOHN R MCCARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01029928A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100461110A
—
IN
01
—
200013394
RR MEDICARE
IN
Enumeration date
05/19/2006
Last updated
06/11/2008
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