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General NPI Number Information
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NPI Number | 1841425899
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Entity Type | Organization
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Legal Business Name | CLARIS EYE CARE & SURGERY, P.A.
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Dates
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Enumeration Date | 05/20/2009
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 14101 FAIRVIEW DR STE 350
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City | BURNSVILLE
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State | MN
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Zip | 55337-2506
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Country | US
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Telephone | 952-522-4900
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Fax | 952-522-4901
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Provider Business Mailing Address
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Address Line | 14101 FAIRVIEW DR STE 350
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City | BURNSVILLE
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State | MN
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Zip | 55337-2506
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Country | US
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Telephone | 952-522-4900
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Fax | 952-522-4901
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH HAROLD CARLSON
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Credential | M.D.
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Telephone | 952-522-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 28116
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License Number State | MN
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