| Doctor Name: | DR. RONALD KEVIN CARROLL |
| NPI Number: | 1215129515 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 5101017465 |
| Business Practice Address: | 6245 Inkster Rd Garden City, MI - 481354001 |
| Business Phone Number: | 7344584486 |
| Business Fax Number: | 7344584496 |
| Mailing Address: | 197 Laurel Ln, CANTON |
| State: | MI |
| Postal Code: | 481874591 |
| Phone Number: | 8657765333 |
| Fax Number: | |
| NPI Enumeration Date: | 08/10/2007 |
| NPI Last Update Date: | 04/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101017465 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |