Individual
JEFFREY O CARLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 MED TECH PKWY, SUITE 1, JOHNSON CITY, TN 37604-4004
(423) 929-2111
(423) 929-0497
Mailing address
110 MED TECH PKWY, SUITE 1, JOHNSON CITY, TN 37604-4004
(423) 929-2111
(423) 929-0497
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD38624
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3898262
—
TN
01
—
P00163835
PALMETTO RAILROAD MEDICAR
TN
Enumeration date
05/03/2006
Last updated
12/21/2009
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