Carlson, Russell Martin

Carlson, Russell Martin is an individual health care provider with primary practice located at 520 Valley View Dr , Moline IL 61265-6152. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Carlson, Russell Martin can be contacted via phone (309) 762-3621.

Contact Information

Primary practice address
520 Valley View Dr Moline IL 61265-6152
Phone: (309) 762-3621
Fax: (309) 762-3690
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 135000650 Illinois

Profile Details

NPI number 1023271137
LBN Legal business name Carlson, Russell Martin
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2008
Last updated May 6th, 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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