Provider Demographics
NPI:1124008255
Name:CARROLL-CHEN, PATRICIA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:CARROLL-CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13640 N 99TH AVE
Mailing Address - Street 2:SUITE #300
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2861
Mailing Address - Country:US
Mailing Address - Phone:623-875-2600
Mailing Address - Fax:623-875-2621
Practice Address - Street 1:13640 N 99TH AVE
Practice Address - Street 2:SUITE #300
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2861
Practice Address - Country:US
Practice Address - Phone:623-875-2600
Practice Address - Fax:623-875-2621
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24787207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ115597Medicare PIN
AZZ25272Medicare PIN
AZG46124Medicare UPIN