MEDICARE: JOHN WINSLOW CARLTON M.D.

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
1	174400000X	Specialist	19957	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1659445633	OTHER	CO	NPI JOHN W CARLTON

General Provider Information

NPI Number	:	1659445633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WINSLOW CARLTON M.D.

Provider Business Mailing Address
First Line	:	1107 S. LEMAY AVE
Second Line	:	SUITE 300
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3955
Country	:	US
Telephone Number	:	970-493-7442
Fax Number	:	970-493-2900

Provider Business Practice Location Address
First Line	:	2695 ROCKY MOUNTAIN AVE.
Second Line	:	SUITE 200
City	:	LOVELAND
State	:	CO
Zip	:	80538-9075
Country	:	US
Telephone Number	:	970-493-7442
Fax Number	:	970-493-2990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	08/03/2010

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