Carlson, Douglas W

Carlson, Douglas W is an individual health care provider with primary practice located at 301 N 8Th St Suite Pav4A, Springfield IL 62701-1041. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Carlson, Douglas W can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
301 N 8Th St Suite Pav4A Springfield IL 62701-1041
Phone: (217) 545-8000
Fax: (217) 545-2303
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-136399 Illinois
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 036-136399 Illinois

Profile Details

NPI number 1669490132
LBN Legal business name Carlson, Douglas W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Sep 27th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669490132 NPPES
Missouri MEDICAID 103810102

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