KENNETH CARROLL M.D. NPI 1205990330

NPI Information

  • NPI: 1205990330
  • Provider Name: KENNETH CARROLL, M.D.
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Individual
  • Address: 461 COOK ST
    SUITE B
    ROYSTON, GA
    ZIP 30662
  • Phone: (706) 245-1877

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NPI Details

Kenneth Carroll, M.D. is an obstetrics gynecology in Royston, GA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Kenneth Carroll, M.D. NPI is 1205990330. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

461 COOK ST
SUITE B
ROYSTON, GA
ZIP 30662-003
Phone: (706) 245-1877
Fax: (706) 245-1433

The enumeration date for this NPI number is 12/21/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology018369GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1975810OTHERGEORGIABCBS PIN NUMBER
216BDCWHMEDICARE ID-TYPE UNSPECIFIEDGEORGIAOPTED OUT
34505967OTHERGEORGIAAETNA PROV NUMBER
4D39556MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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