Healthcare Provider Details

I. General information

NPI: 1144708017
Provider Name (Legal Business Name): ERIC CARLSEN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

4619 KENNY RD
COLUMBUS OH
43220-2779
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-4945
  • Fax:
Mailing address:
  • Phone: 800-554-2695
  • Fax: 614-442-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35.155173
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: