Provider Demographics
NPI:1780643098
Name:CARROLL, SEAN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:THOMAS
Last Name:CARROLL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:MCHK-PE
Mailing Address - Street 2:1 JARRETT WHITE ROAD
Mailing Address - City:TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5000
Mailing Address - Country:US
Mailing Address - Phone:808-433-6212
Mailing Address - Fax:808-433-6227
Practice Address - Street 1:ONE JARRETT WHITE RD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER, DEPARTMENT OF PEDIATRICS
Practice Address - City:TRIPLER AMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5000
Practice Address - Country:US
Practice Address - Phone:808-433-4165
Practice Address - Fax:808-433-6227
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-18880208000000X
IN01047208A2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics