Provider Demographics
NPI:1508190737
Name:CARLETON FAMILY MEDICINE, PLLC
Entity Type:Organization
Organization Name:CARLETON FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARLETON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-231-3159
Mailing Address - Street 1:1011 6TH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-1825
Mailing Address - Country:US
Mailing Address - Phone:515-231-3159
Mailing Address - Fax:314-770-6046
Practice Address - Street 1:1011 6TH ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-1825
Practice Address - Country:US
Practice Address - Phone:515-231-3159
Practice Address - Fax:314-770-6046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
76955OtherBCBS WELLMARK
76955OtherBCBS WELLMARK