Healthcare Provider Details

I. General information

NPI: 1326008368
Provider Name (Legal Business Name): CHAD THOMAS CARLSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 OFFICE PLAZA DR N STE 140
WEST DES MOINES IA
50266-1207
US

IV. Provider business mailing address

7601 OFFICE PLAZA DR N STE 140
WEST DES MOINES IA
50266-1207
US

V. Phone/Fax

Practice location:
  • Phone: 515-221-1102
  • Fax: 515-221-1272
Mailing address:
  • Phone: 515-221-1102
  • Fax: 515-221-1272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number36501
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: