Individual
ANN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
269 S CANDY LN, COTTONWOOD, AZ 86326-4158
(928) 639-6150
(928) 639-6561
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 773-2559
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17955
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050074310
RR MEDICARE
AZ
05
—
237637
—
AZ
01
—
ZWCGCR
GROUP MEDICARE NUMBER
AZ
Enumeration date
02/07/2006
Last updated
12/04/2015
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