Individual
DR. BRENDAN THOMAS MORE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
188 W HEBBLE AVE, FAIRBORN, OH 45324-4960
(614) 893-0910
(614) 879-4169
Mailing address
330 TAYLOR BLAIR RD, THE NEUROSCIENCE ALLIANCE, LLC, WEST JEFFERSON, OH 43162-9714
(614) 893-0910
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
35-061694
OH
2084F0202X
Forensic Psychiatry Physician
61694
OH
2084P0800X
Psychiatry Physician
Primary
35-061694
OH
2084P0800X
Psychiatry Physician
61694
OH
Other
Enumeration date
08/31/2006
Last updated
06/15/2022
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