Individual
DR. JOEL CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7322 236TH AVE, SALEM, WI 53168-9664
(262) 577-8460
(262) 577-8399
Mailing address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 656-3313
(262) 577-8399
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
24302
WI
207Q00000X
Family Medicine Physician
Primary
24302-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30507800
—
WI
01
—
F400411291
MEDICARE (ILLINOIS)
IL
01
—
K400411276
MEDICARE
WI
Enumeration date
08/07/2006
Last updated
12/03/2018
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