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Individual

MARK LUTHER CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-2273
(417) 269-8851
Mailing address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-2273
(417) 269-8851

Taxonomy

Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
101949
MO

Other

Enumeration date
03/15/2007
Last updated
10/12/2018
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