Provider Demographics
NPI:1124415005
Name:KARLSON, STEVEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KARLSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 E BELLA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-5791
Mailing Address - Country:US
Mailing Address - Phone:224-805-3450
Mailing Address - Fax:
Practice Address - Street 1:4710 E ROSE GARDEN LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4264
Practice Address - Country:US
Practice Address - Phone:480-214-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-18
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.298207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist