Individual
CHRISTOPHER LANCE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N CLAYVIEW DR, LIBERTY, MO 64068-1115
(816) 781-9222
Mailing address
7319 N NEVADA AVE, PARKVILLE, MO 64152-1191
(636) 346-4619
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-34384
KS
207P00000X
Emergency Medicine Physician
Primary
2010010433
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316168966
—
MO
01
—
R86000039
MO MEDICARE
MO
Enumeration date
05/01/2007
Last updated
07/31/2013
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