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NPI Code Detail

MEDICARE: DR. JOHN G CARSON M.D.

MEDICARE:  DR. JOHN G CARSON  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
1208600000XSurgery Physician36117446IL
2208600000XSurgery PhysicianA85584CA
32086S0129XVascular Surgery PhysicianA85584CA
42086S0129XVascular Surgery Physician36117446IL
52086S0129XVascular Surgery PhysicianMD21625ME

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 : 1871507228
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN G CARSON M.D.
Provider Business Mailing Address
First Line : 92 CAMPUS DR STE D
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-7229
Country : US
Telephone Number : 207-662-8900
Fax Number :
Provider Business Practice Location Address
First Line : 92 CAMPUS DR STE D
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-7229
Country : US
Telephone Number : 207-662-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 04/17/2023

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Directions to “ DR. JOHN G CARSON M.D.” Practice Location

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