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Individual

DR. GREGG W CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
310 S PENN ST, STE 204, ABERDEEN, SD 57401-4553
(605) 225-1636
(605) 229-2434
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2857
(605) 622-2859

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1897
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15824
ND MEDICAID
ND
Enumeration date
12/04/2006
Last updated
11/01/2011
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