Individual
CARROLL ROBERT WETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171
(660) 890-8490
Mailing address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R2H39
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206786600
—
MO
Enumeration date
07/24/2006
Last updated
11/16/2021
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