NPI Code Detail JSON Logo

1295783637 NPI number — ROBERT R CARLSON M.D.

NPI Number: 1295783637
Health Care Provider/Practitioner: ROBERT R CARLSON M.D.

Information about “1295783637” NPI (ROBERT R CARLSON M.D.) exists in 1295783637 in HTML format HTML  |  1295783637 in plain Text format TXT  |  1295783637 in PDF (Portable Document Format) PDF  |  1295783637 in an XML format XML  formats.

NPI Number : 1295783637 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295783637",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARLSON",
    "FirstName": "ROBERT",
    "MiddleName": "R",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CARLSON",
    "OtherFirstName": "BOB",
    "OtherMiddleName": "R",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "PO BOX 157",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOVELADY",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75851-0157",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "970-580-6910",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1320 N UNIVERSITY DR STE A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NACOGDOCHES",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75961-4270",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "936-568-9600",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/05/2006",
    "LastUpdateDate": "10/01/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208600000X",
          "TaxonomyName": "Surgery Physician",
          "LicenseNumber": "5647",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208600000X",
          "TaxonomyName": "Surgery Physician",
          "LicenseNumber": "10187",
          "LicenseNumberStateCode": "SD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208600000X",
          "TaxonomyName": "Surgery Physician",
          "LicenseNumber": "33347",
          "LicenseNumberStateCode": "IA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208600000X",
          "TaxonomyName": "Surgery Physician",
          "LicenseNumber": "K3890",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.