Individual
DR. CHESTER L. CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5212 VILLAGE PKWY, ROGERS, AR 72758-8104
(479) 657-6888
Mailing address
5212 VILLAGE PKWY, ROGERS, AR 72758-8104
(479) 657-6888
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E-5307
AR
208D00000X
General Practice Physician
Primary
E-5307
AR
208D00000X
General Practice Physician
E5307
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166986003
—
AR
01
—
5H348
ARKANSAS BLUE CROSS
AR
Enumeration date
04/04/2007
Last updated
04/02/2015
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