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Individual

CHARLES W CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
56 CEDAR ST, TIPTON, IA 52772-1705
(563) 886-2195
(563) 886-3268
Mailing address
PO BOX 2027, IOWA CITY, IA 52244-2027
(319) 339-3855
(319) 358-2737

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25952
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1252346
IA
Enumeration date
06/14/2006
Last updated
03/18/2008
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