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NPI Code Detail

MEDICARE: DR. RAYMOND EUGENE CARLSON O.D.

MEDICARE: DR. RAYMOND EUGENE CARLSON O.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
1152W00000XOptometrist9893TCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811065378
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND EUGENE CARLSON O.D.
Provider Business Mailing Address
First Line : 3750 N BLACKSTONE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-5306
Country : US
Telephone Number : 559-227-2529
Fax Number : 559-227-2344
Provider Business Practice Location Address
First Line : 3750 N BLACKSTONE AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-5306
Country : US
Telephone Number : 559-227-2529
Fax Number : 559-227-2344
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 02/09/2012

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