Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carroll County Medical Clinic

Organization Family Medicine Physician · NPI 1366752768

Carroll County Medical Clinic is a Family Medicine Physician in Carrollton, Missouri. Licensed in Missouri. Registered with an NPI since 2010.

Licensed in
MO
In the registry since
2010
Specialties on file
4

Practice location Address checks out

1502 N Jefferson St St Ste A B
Carrollton, MO 64633-1948
Phone: (660) 542-3865
Fax: (660) 542-0336
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD106594 (MO)
Family Medicine Physician Taxonomy 207Q00000X · Licence MD109202 (MO)
Internal Medicine Physician Taxonomy 207R00000X · Licence MD106594 (MO)
Pediatric Adolescent Medicine Physician Taxonomy 2080A0000X · Licence MD109202 (MO)

Record details

NPI number1366752768
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Dover — Ceo · (660) 542-1695
NPI enumeratedOctober 19, 2010
Last updated in NPPESOctober 19, 2010
Mailing address1502 N Jefferson St, Suite A B, Carrollton, MO 64633-1948

Other providers in Carrollton