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NPI Code Detail

MEDICARE: IRIS CARSON PA-C

MEDICARE:   IRIS  CARSON  PA-C
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
1363A00000XPhysician Assistant10855GA

General Provider Information

NPI Number : 1144974270
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRIS CARSON PA-C
Provider Business Mailing Address
First Line : 40 LAKERIDGE CT
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-1800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6228 BRADLEY PARK DR
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-3603
Country : US
Telephone Number : 706-322-1486
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2022
Last Update Date : 02/08/2022

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Directions to “ IRIS CARSON PA-C” Practice Location

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