Individual
ERIC CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
933 SELL AVE, SUITE A, CANON CITY, CO 81212-4900
(719) 275-0685
(719) 275-0690
Mailing address
PO BOX 310, CANON CITY, CO 81215-0310
(719) 275-0685
(719) 275-0690
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
30252
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01302520
—
CO
01
—
159056900
US DEPT OF LABOR
—
01
—
29405
ANTHEM BCBS
—
01
—
5502AMPR005587
ANTHEM BCBS NASCO BLUE CA
—
01
—
P00262002
RAILROAD MEDICARE
CO
Enumeration date
01/13/2006
Last updated
07/07/2009
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