Individual
GREGORY CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 365-6487
(719) 364-6488
Mailing address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 365-6487
(719) 364-6488
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
DR.0042262
CO
2086S0129X
Vascular Surgery Physician
Primary
DR.0042262
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46032240
—
CO
Enumeration date
12/30/2005
Last updated
02/10/2020
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