Individual
DR. WAYNE R. CARLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
142 PARKS HALL, ATHENS, OH 45701
(740) 593-2482
(740) 593-0036
Mailing address
142 PARKS HALL, ATHENS, OH 45701
(740) 593-2482
(740) 593-0036
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
34-00-5734C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0938758
—
OH
Enumeration date
02/07/2006
Last updated
04/08/2009
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