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 provides Family Medicine Physician services 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 Not confirmed with CMS for 15 years — call before visiting
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