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General NPI Number Information
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NPI Number | 1790725372
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Entity Type | Individual
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Provider Name | CRAIG L CARLSON MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 1100 E 26TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57105-4023
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Country | US
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Telephone | 605-338-7098
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Fax | 605-335-3505
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Provider Business Mailing Address
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Address Line | 5500 S SPY GLASS CIR
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City | SIOUX FALLS
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State | SD
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Zip | 57108-6406
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Country | US
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Telephone | 605-330-0044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 1642
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License Number State | SD
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