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Individual
DR. JOEL ANDREW CARLSON
Active
Individual
DR. JOEL ANDREW CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
3140
IA
207V00000X
Obstetrics & Gynecology Physician
Primary
O-0407
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010156981
REGENCE-BLUE SHIELD
ID
01
—
546490
DESERET MUTUAL
ID
05
—
807508700
—
ID
01
—
P00355281
RAILROAD MEDICARE
ID
01
—
S6109
BLUE CROSS
ID
Enumeration date
01/18/2006
Last updated
07/19/2012
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