Carlson, Mark O.

Carlson, Mark O. is an individual health care provider with primary practice located at 1605 Douglas St , Sioux City IA 51105-1109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Carlson, Mark O. can be contacted via phone (712) 234-1005.

Contact Information

Primary practice address
1605 Douglas St Sioux City IA 51105-1109
Phone: (712) 234-1005
Fax: (712) 234-0015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 27247 Iowa

Profile Details

NPI number 1609837368
LBN Legal business name Carlson, Mark O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Nov 22nd, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609837368 NPPES
Nebraska MEDICAID 10025457800
Nebraska MEDICAID 6004143
Nebraska Other IB1201001
Nebraska MEDICAID 2059956

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