Individual
DR. MICHAEL JONATHAN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N 500 W, STE 121, PROVO, UT 84604-3305
(801) 373-7350
(801) 812-5401
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5477
NE
207X00000X
Orthopaedic Surgery Physician
Primary
8283131-1205
UT
207X00000X
Orthopaedic Surgery Physician
A114736
CA
Other
Enumeration date
04/26/2007
Last updated
11/27/2023
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