Provider Demographics
NPI:1447218227
Name:CARLSON, JOHN F (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:CARLSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 DUNNING ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2070
Mailing Address - Country:US
Mailing Address - Phone:603-542-2571
Mailing Address - Fax:603-542-3550
Practice Address - Street 1:5 DUNNING ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2070
Practice Address - Country:US
Practice Address - Phone:603-542-2571
Practice Address - Fax:603-542-3550
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH4147509OtherMVP
NH30223951Medicaid
NH9702264OtherCIGNA
VT1012202Medicaid
NHG87101Medicare UPIN
VT1012202Medicaid