Individual
MS. KIMBERLY JEANNE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3023 N BALLAS RD STE 500, SAINT LOUIS, MO 63131-2359
(314) 996-7930
(314) 996-7935
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7930
(314) 996-7935
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56232
WI
207RR0500X
Rheumatology Physician
Primary
2015027133
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982847042
—
WI
Enumeration date
04/19/2009
Last updated
02/12/2021
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