Provider Demographics
NPI:1629500913
Name:CARROLL, EMILY KINGRY (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KINGRY
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:KINGRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 TREELINE PARK
Mailing Address - Street 2:APT 1306
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-7407
Mailing Address - Country:US
Mailing Address - Phone:207-712-3911
Mailing Address - Fax:
Practice Address - Street 1:250 TREELINE PARK
Practice Address - Street 2:APT 1306
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-7407
Practice Address - Country:US
Practice Address - Phone:207-712-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program