Provider Demographics
NPI:1508811860
Name:CARROLL, JOHN D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:CARROLL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:10689 HARDIN VALLEY RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1504
Practice Address - Country:US
Practice Address - Phone:865-692-1220
Practice Address - Fax:865-692-1499
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2017-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD38722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I03103Medicare UPIN