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NPI Code Detail

MEDICARE: DR. JAMES MICHAEL CARLSON DO

MEDICARE: DR. JAMES MICHAEL CARLSON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianDO23967OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104800994
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES MICHAEL CARLSON DO
Provider Business Mailing Address
First Line : 2400 NE NEFF RD
Second Line : STE A
City : BEND
State : OR
Zip : 97701-6752
Country : US
Telephone Number : 541-389-3300
Fax Number : 541-389-8115
Provider Business Practice Location Address
First Line : 2400 NE NEFF RD
Second Line : STE A
City : BEND
State : OR
Zip : 97701-6752
Country : US
Telephone Number : 541-389-3300
Fax Number : 541-389-8115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 03/14/2014

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Directions to “ DR. JAMES MICHAEL CARLSON DO” Practice Location

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