Individual
CONNIE JO MCCARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
313 PARKS HALL, ATHENS, OH 45701
(740) 593-2444
(740) 593-0905
Mailing address
1102 ALTAMONTE DR, ATHENS, OH 45701-8048
(740) 592-1230
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34002567
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0535326
—
OH
01
—
34002567
OHIO LICENSE
OH
Enumeration date
01/30/2006
Last updated
03/07/2023
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