Individual
STEPHEN JOHN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
819 ASH ST, SPOONER, WI 54801-1201
(715) 635-2111
Mailing address
N2296 LITTLE LONG LAKE RD, SHELL LAKE, WI 54871-8826
(715) 468-2205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19960
WI
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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