Individual
THOMAS CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3209
Mailing address
3629 LINDENWOOD ST, SIOUX CITY, IA 51104-2255
(651) 245-6304
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
65424-21
WI
207L00000X
Anesthesiology Physician
Primary
R-09509
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2012
Last updated
12/30/2021
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