Individual
KEITH HAROLD CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14101 FAIRVIEW DR STE 350, BURNSVILLE, MN 55337-2506
(952) 522-4900
(952) 522-4901
Mailing address
14101 FAIRVIEW DR STE 350, BURNSVILLE, MN 55337-2506
(952) 522-4900
(952) 522-4901
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
28116
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679548879
—
MN
Enumeration date
02/21/2006
Last updated
05/22/2024
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