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NPI Code Detail

MEDICARE: DR. DAVID J CARLSON M.D.

MEDICARE: DR. DAVID J CARLSON M.D.
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
1208600000XSurgery Physician01025538AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2020021454OTHERINRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000082348OTHERINANTHEM BLUE CROSS/SHIELD
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902805807
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J CARLSON M.D.
Provider Business Mailing Address
First Line : 520 MARY ST
Second Line : SUITE 520
City : EVANSVILLE
State : IN
Zip : 47710-1682
Country : US
Telephone Number : 812-424-8231
Fax Number : 812-435-8794
Provider Business Practice Location Address
First Line : 520 MARY ST
Second Line : SUITE 520
City : EVANSVILLE
State : IN
Zip : 47710-1682
Country : US
Telephone Number : 812-424-8231
Fax Number : 812-435-8794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 05/08/2015

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Directions to “ DR. DAVID J CARLSON M.D.” Practice Location

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