Individual
GLEN S CARLSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309
(404) 605-3247
(404) 609-6645
Mailing address
PO BOX 491028, LAWRENCEVILLE, GA 30049
(404) 605-3247
(404) 609-6645
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
032149
GA
Other
Enumeration date
03/01/2006
Last updated
07/08/2007
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