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NPI Code Detail

MEDICARE: ANJALEE GOEL CARLSON DO

MEDICARE: ANJALEE GOEL CARLSON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician7775KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1033D00198OTHERKSMEDICARE WPS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053609107
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANJALEE GOEL CARLSON DO
Provider Business Mailing Address
First Line : 20375 W 151ST ST STE 251
Second Line :
City : OLATHE
State : KS
Zip : 66061-7253
Country : US
Telephone Number : 913-393-4888
Fax Number : 913-764-6884
Provider Business Practice Location Address
First Line : 2090 W DARTMOUTH ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-6869
Country : US
Telephone Number : 913-356-8300
Fax Number : 913-356-8711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2011
Last Update Date : 04/13/2022

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