Provider Demographics
NPI:1871704502
Name:PATRICIA A CARROLL, M.D.P.C
Entity type:Organization
Organization Name:PATRICIA A CARROLL, M.D.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-875-2600
Mailing Address - Street 1:13640 N 99TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2861
Mailing Address - Country:US
Mailing Address - Phone:623-875-2600
Mailing Address - Fax:623-875-2621
Practice Address - Street 1:13640 N 99TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2861
Practice Address - Country:US
Practice Address - Phone:623-875-2600
Practice Address - Fax:623-875-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ115596Medicare PIN
AZZ115597Medicare PIN