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Individual

MR. BARRY SCOTT CARROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
244 HIGHWAY 65 N, SUITE 1, CLINTON, AR 72031-6390
(501) 745-6100
(501) 745-6128
Mailing address
PO BOX 808, CLINTON, AR 72031-0808
(501) 745-6100
(501) 745-6128

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C8231
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124580001
AR
01
5532098
AETNA
AR
01
5J262
BLUECROSS ARKANSAS
AR
01
5J262B477
MEDICARE PIN
AR
01
P00014280
RAILROAD PIN
AR
Enumeration date
06/17/2005
Last updated
04/20/2012
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