Individual
DR. CARL SANFORD CARLSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 FT SANDERS WEST BLVD, #307, KNOXVILLE, TN 37922
(865) 693-7155
(865) 693-5676
Mailing address
200 FT SANDERS WEST BLVD, #307, KNOXVILLE, TN 37922
(865) 693-7155
(865) 693-5676
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD09616
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376529016
CAHABA
AL
01
—
3195310
MEDICARE OTHER
TN
05
—
3195310
—
TN
Enumeration date
12/15/2005
Last updated
01/04/2010
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