Individual
DR. MATTHEW CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 376-0577
Mailing address
PO BOX 1810, GULFPORT, MS 39502
(228) 575-1194
(228) 575-2917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20383
MS
208M00000X
Hospitalist Physician
Primary
20383
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20383
MISSISSIPPI STATE LICENSE
MS
Enumeration date
10/20/2005
Last updated
09/14/2023
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