Organization
BRUCE D CARLSON M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE D CARLSON M.D. (PHYSICIAN)
(541) 576-2343
Entity
Organization
Contact information
Practice address
87480 SPRUCE LN, CHRISTMAS VALLEY, OR 97641
(541) 576-2343
(541) 576-2869
Mailing address
PO BOX 377, CHRISTMAS VALLEY, OR 97641-0377
(541) 576-2343
(541) 576-2869
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080385000
BLUE CROSS BLUE SHIELD
OR
05
—
182817
—
OR
Enumeration date
12/26/2006
Last updated
09/26/2008
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