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Individual
JOHN-THOMAS CARSON
Active
Individual
JOHN-THOMAS CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2405
SC
363AS0400X
Surgical Physician Assistant
2405
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2322PA
—
SC
Enumeration date
09/16/2015
Last updated
05/19/2021
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