Individual
DR. GEORGINA LENORE DIXON CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 CURVE CREST BOULEVARD, STILLWATER MEDICAL GROUP, STILLWATER, MN 55082-6040
(651) 439-1234
(651) 275-3325
Mailing address
1500 CURVE CREST BOULEVARD, STILLWATER, MN 55082-6040
(651) 439-1234
(651) 275-3325
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25611
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32108100
—
WI
05
—
885563300
—
MN
Enumeration date
12/21/2005
Last updated
06/06/2012
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