Individual
DR. BRENT S CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 GLENN HENDREN DR, LIBERTY, MO 64068-9625
(816) 792-7000
Mailing address
PO BOX 411375, KANSAS CITY, MO 64141-1375
(816) 781-9222
(816) 781-9250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
115625
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204703714
—
MO
01
—
35373016
BCBS MO
MO
Enumeration date
08/10/2005
Last updated
01/08/2024
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