Provider Demographics
NPI:1093943086
Name:CARLSON, JOSHUA NOREN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:NOREN
Last Name:CARLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911810
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-1810
Mailing Address - Country:US
Mailing Address - Phone:435-216-7032
Mailing Address - Fax:866-836-9639
Practice Address - Street 1:585 E RIVERSIDE DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-216-7032
Practice Address - Fax:866-836-9639
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD171333207WX0107X
UT10574949-1205207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ378285Medicaid
UT1009787Medicaid