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NPI Code Detail

MEDICARE: R LYNN CARLSON MD PC MEDICENTER

MEDICARE: R LYNN CARLSON MD PC MEDICENTER
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
1207Q00000XFamily Medicine Physician

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 : 1811135247
Entity Type Code : Organization
Provider Name (Legal Business Name) : R LYNN CARLSON MD PC MEDICENTER
Provider Business Mailing Address
First Line : 10543 KENAI SPUR HWY
Second Line :
City : KENAI
State : AK
Zip : 99611-7812
Country : US
Telephone Number : 907-283-9118
Fax Number : 907-283-5341
Provider Business Practice Location Address
First Line : 10543 KENAI SPUR HWY
Second Line :
City : KENAI
State : AK
Zip : 99611-7812
Country : US
Telephone Number : 907-283-9118
Fax Number : 907-283-5341
Authorized Official
Title or Position : MANAGING PHYSICIAN
Name : R LYNN CARLSON
Credential : MD
Telephone Number : 907-283-9118
Provider Enumeration Date : 01/22/2009
Last Update Date : 02/14/2014

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Directions to “R LYNN CARLSON MD PC MEDICENTER ” Practice Location

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