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Individual

GREGORY H. CARLSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
204 S 2ND ST, DANVILLE, KY 40422-1804
(859) 236-9819
(859) 236-2192
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
32606
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000306671
ANTHEM BCBS PROV. #
KY
01
000000476307
ANTHEM BCBS PROV. #
KY
01
1135712
PASSPORT HEALTH PROV. #
KY
01
1206474
GATEWAY HEALTH
FL
05
1859601
KY
01
50001834
PASSPORT HEALTH GRP #
KY
01
564019
STERLING HEALTH
KY
01
P00113978
RAILROAD MCARE #
KY
Enumeration date
09/14/2005
Last updated
11/23/2016
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