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Individual

WALTER O CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
810 E 23RD ST, SIOUX FALLS, SD 57105-2135
(605) 331-5890
(605) 336-3974
Mailing address
PO BOX 5116, SIOUX FALLS, SD 57117-5116
(605) 331-5890
(605) 336-3974

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1241
SD
207X00000X
Orthopaedic Surgery Physician
26304
IA
207X00000X
Orthopaedic Surgery Physician
47259
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200010316
RAILROAD MEDICARE
SD
05
6400350
SD
Enumeration date
08/02/2006
Last updated
01/16/2010
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