David R Carroll,MD, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

16117 Issued in MS

Legal business name

DAVID R CARROLL,MD, PLLC

Practice address

971 Lakeland Dr
Suite 656
Jackson, MS 39216-4643

Phone

(601) 366-6606

Fax

(601) 366-6647

NPI assigned

Feb 2, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle L Campbell

Title

Practice Administrator

Phone

(601) 366-6606

Specialties & licenses 1

Addresses

Other names 1

• Surgical Specialist of Jackson Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Beard, RNFA

  • Surgical Physician Assistant
  • Jackson, MS
  • NPI 1629307970
  NPD (past)
• Matthew J Hunt, MD

  • Surgery Physician
  • Madison, AL
  • NPI 1508065129
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1124266952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 656",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-6606",
            "fax_number": "601-366-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 656",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-366-6606",
            "fax_number": "601-366-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R CARROLL,MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "601-366-6606"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MS",
            "license": "16117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Specialist of Jackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marsha Williams Darnell, LPC
• Damon Allen Darsey, M.D.
• Mary Ann Moss Darsey
• Omkar Hemant Dave, M.D.
• David a. Mosal, DDS, PA
• David S. Miller, MD, PLLC
• Jamie V Davidson, NP
• John Clayton Davidson I, MD
• Karen Whitfield Davidson, FNP-C
• Lindsey Timm Davidson, LCSW

• Specialist in Jackson, MS
• Providers in Jackson, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.