Individual
DR. RICHARD SCOTT CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
851 EASTPORT CENTRE DR, VALPARAISO, IN 46383-2909
(219) 464-8223
(219) 531-2356
Mailing address
502 MARQUETTE ST, VALPARAISO, IN 46383-2509
(219) 464-8223
(219) 531-2356
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009441
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000549868
ANTHEM BC.BS
IN
01
—
01635025
BCBS
IL
05
—
036059451
—
IL
05
—
200883420
—
IN
01
—
2151005
FIRST HEALTH
IL
01
—
P00082449
MEDIARE RAILROAD
IL
Enumeration date
08/11/2005
Last updated
11/20/2024
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