Individual
MARK D. CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
717 N 190TH PLZ, STE. # 1100, ELKHORN, NE 68022-3917
(402) 815-1700
(402) 815-1959
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0431506
KS
207V00000X
Obstetrics & Gynecology Physician
Primary
24086
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026301600
—
NE
05
—
1144347568
—
IA
05
—
47068731799
—
NE
Enumeration date
03/22/2007
Last updated
06/29/2015
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