Provider Demographics
NPI:1508047010
Name:CARROLL, JAMES ALFRED (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALFRED
Last Name:CARROLL
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:1 ARMORY RD
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5770
Mailing Address - Country:US
Mailing Address - Phone:207-430-5266
Mailing Address - Fax:207-430-6221
Practice Address - Street 1:ONE AYER'S CIRCLE, BLDG H-1, PORTSMOUTH NAVAL SHIPYARD
Practice Address - Street 2:NAVAL BRANCH HEALTH CLINIC
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03804-5000
Practice Address - Country:US
Practice Address - Phone:207-438-2391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2015-01-09
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Provider Licenses
StateLicense IDTaxonomies
MEPA001112363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical