Individual
DR. DOUGLAS J CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2950 CURVE CREST BLVD W, STILLWATER, MN 55082-5085
(651) 275-3000
(651) 275-3027
Mailing address
1719 TOWER DR W, STE 100, STILLWATER, MN 55082-7512
(651) 275-3000
(651) 275-3027
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
21564
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180008787
RAILROAD MEDICARE
MN
01
—
180046280
RAILROAD MEDICARE
WI
05
—
241590900
—
MN
Enumeration date
06/15/2005
Last updated
03/07/2014
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