Individual
DR. KURTIS M. CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4929 OAK STREET, QUINCY, IL 62305-2839
(217) 222-2020
(217) 223-9582
Mailing address
4929 OAK STREET, QUINCY, IL 62305
(217) 222-2020
(217) 223-9582
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008272
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132031
BLUE CROSS BLUE SHIELD
IL
01
—
258761
HEALTHLINK
IL
Enumeration date
08/19/2006
Last updated
05/29/2015
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