Individual
DR. LEE VAN CARROLL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1825 PARK PL, MONTGOMERY, AL 36106-1149
(334) 834-3671
Mailing address
1825 PARK PL, MONTGOMERY, AL 36106-1149
(334) 834-3671
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
61214
TN
2085R0202X
Diagnostic Radiology Physician
Primary
MD.37222
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37222
STATE MEDICAL LICENSE
AL
Enumeration date
05/28/2015
Last updated
06/21/2021
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