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Individual

DR. CRAIG GRASON CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
1511 ONYX CIR, LONGMONT, CO 80504-7805
(303) 776-5298
(303) 682-2785
Mailing address
1908 THOMES AVE STE 12550, CHEYENNE, WY 82001-3527
(757) 282-3953

Taxonomy

Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
0055838
CO
2084N0400X
Neurology Physician
DR.55838
CO
2084N0400X
Neurology Physician
H0061118
MD
2084N0600X
Clinical Neurophysiology Physician
Primary
OS13733
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0055838
LICENSE
CO
Enumeration date
12/22/2005
Last updated
10/20/2025
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