Individual
DR. GLENN H CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4235 SECOR RD, TOLEDO, OH 43623-4231
(419) 479-5556
(419) 479-3976
Mailing address
4235 SECOR RD, TOLEDO, OH 43623-4231
(419) 479-5556
(419) 479-3976
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35055995
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0682060
—
OH
01
—
TO9121521
GROUP MEDICARE PIN
OH
Enumeration date
08/17/2005
Last updated
08/04/2008
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