Provider Demographics
NPI:1720032782
Name:KARLSSON, FINNBOGI O (MD)
Entity Type:Individual
Prefix:
First Name:FINNBOGI
Middle Name:O
Last Name:KARLSSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:PEEL
Mailing Address - State:AR
Mailing Address - Zip Code:72668-0036
Mailing Address - Country:US
Mailing Address - Phone:870-688-5533
Mailing Address - Fax:870-436-2603
Practice Address - Street 1:815 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2914
Practice Address - Country:US
Practice Address - Phone:870-688-5533
Practice Address - Fax:870-436-2603
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4172207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154708001Medicaid
AR154708001Medicaid
ARF88223Medicare UPIN