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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 11 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 1194835181 NPPES
Missouri MEDICAID 1194835181
Missouri MEDICAID 187019003
Missouri MEDICAID 200454170A

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