Individual
CHRISTIAN LACELLE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(215) 427-5234
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 662-1800
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
11931633-1205
UT
2085P0229X
Pediatric Radiology Physician
MD479323
PA
2085R0202X
Diagnostic Radiology Physician
01058718A
IN
2085R0202X
Diagnostic Radiology Physician
11931633-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
MD479323
PA
Other
Enumeration date
10/27/2005
Last updated
08/30/2023
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