Individual
JEFFREY R CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 NAT TURNER BLVD S, NEWPORT NEWS, VA 23606-2899
(757) 596-1900
(866) 420-0168
Mailing address
250 NAT TURNER BLVD S, NEWPORT NEWS, VA 23606-2899
(757) 596-1900
(866) 420-0168
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101059179
VA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
0101059179
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208171
ANTHEM BC
—
05
—
6407188
—
VA
Enumeration date
12/15/2006
Last updated
01/12/2011
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