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Individual

DR. STEPHEN BRENT CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4411 THE 25 WAY NE, SUITE 150, ALBUQUERQUE, NM 87109-5857
(505) 332-6919
(505) 332-6921
Mailing address
4411 THE 25 WAY NE, SUITE 150, ALBUQUERQUE, NM 87109-5857
(505) 332-6919
(505) 332-6921

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
A83492
CA
2085N0700X
Neuroradiology Physician
Primary
MD2013-0668
NM
2085R0202X
Diagnostic Radiology Physician
35.134086
OH
2085R0202X
Diagnostic Radiology Physician
ME160184
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42482780
NM
Enumeration date
12/08/2006
Last updated
01/12/2023
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