Individual
TRENT PATRICK CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1409 RIDGEWAY RD, MARSHALL, MN 56258-2153
(612) 385-7105
Mailing address
1409 RIDGEWAY RD, MARSHALL, MN 56258-2153
(507) 537-9007
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32114
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072390800
—
MN
Enumeration date
07/13/2006
Last updated
05/03/2021
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