Individual
DR. CHARLES PATRICK CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
89 SYLVANIA DR, 2ND FL, DAYTON, OH 45440-3237
(937) 427-8900
(937) 427-1710
Mailing address
89 SYLVANIA DR, 2ND FL, DAYTON, OH 45440-3237
(937) 427-8900
(937) 427-1710
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35038423
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
35038423
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0436415
—
OH
Enumeration date
06/30/2005
Last updated
07/10/2017
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