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Individual

JEFFREY LYNN CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1000 MICHIGAN ST, SIDNEY, OH 45365-2404
(937) 492-1211
(937) 492-6557
Mailing address
1000 MICHIGAN ST, SIDNEY, OH 45365-2404
(937) 492-1211
(937) 492-6557

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003576
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
7054576-0501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3133424
OH
Enumeration date
10/08/2008
Last updated
07/26/2011
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