Provider Demographics
NPI:1619016276
Name:MCCARRON, PATRICIA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:MCCARRON
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 1:301 CLUB PINES DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:252-830-6260
Mailing Address - Fax:
Practice Address - Street 1:2415 WEST VERNONN AVE
Practice Address - Street 2:CASWELL CENTER
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-3321
Practice Address - Country:US
Practice Address - Phone:252-208-4044
Practice Address - Fax:252-208-4035
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8601670208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406105Medicaid
NC3406105Medicaid