Carlson, Jay W
Carlson, Jay W is an individual health care provider with primary practice located at 2055 S Fremont Ave Ste 200, Springfield MO 65804-2206. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecologic Oncology, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Gynecologic Oncology is his primary health care specialty. Carlson, Jay W can be contacted via phone (417) 820-3554.Contact Information
Primary practice address
2055 S Fremont Ave Ste 200
Springfield MO 65804-2206
Phone: (417) 820-3554
Fax: (417) 820-3587
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Gynecologic Oncology | 207VX0201X | JC015918 | Michigan |
Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | 4038 | Iowa |
Allopathic & Osteopathic Physicians / Gynecologic Oncology | 207VX0201X | 4038 | Iowa |
Allopathic & Osteopathic Physicians / Gynecologic Oncology | 207VX0201X | 2011006588 | Missouri |
Profile Details
NPI number | 1194835181 |
---|---|
LBN Legal business name | Carlson, Jay W |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 30th, 2006 |
Last updated | Mar 30th, 2013 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1194835181 | NPPES |
Missouri | MEDICAID | 1194835181 | |
Missouri | MEDICAID | 187019003 | |
Missouri | MEDICAID | 200454170A |
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