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Contact Information

TRAVIS R CARROLL, MD
1200 MEMORIAL DR
DALTON, GA30720-2529
 Phone: 706-264-1897
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neonatal-Perinatal Medicine

2080N0001X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for TRAVIS R CARROLL · (Male)

NPI # 1114137551
Status Active
Credentials MD
Entity Individual
Enumeration date 05/23/2007
Last updated 01/12/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 074111
  • TX License # N5608
  • GA Medicaid 003161386A
  • TX Medicaid 213538601
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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