Individual
DR. EDWARD E CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
433 OAKLAND LN, ELKHORN, WI 53121-1659
(262) 723-4455
Mailing address
433 OAKLAND LN, ELKHORN, WI 53121-1659
(262) 723-4455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18826
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0161173024 1
—
IL
05
—
31204000
—
WI
Enumeration date
08/29/2006
Last updated
11/11/2014
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