Provider Demographics
NPI:1326282153
Name:CARRIGAN, WARREN V (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:V
Last Name:CARRIGAN
Suffix:
Gender:M
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:PO BOX 49237
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32240-9237
Mailing Address - Country:US
Mailing Address - Phone:904-860-2761
Mailing Address - Fax:
Practice Address - Street 1:632 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-3734
Practice Address - Country:US
Practice Address - Phone:904-860-3761
Practice Address - Fax:904-249-9764
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1076912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01233477OtherRR MEDICARE
FL008928800Medicaid
FL008928800Medicaid