Provider Demographics
NPI:1790938702
Name:CARLSON, BRENT DIXON (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:DIXON
Last Name:CARLSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 OAKLEAF WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-2245
Mailing Address - Country:US
Mailing Address - Phone:715-832-1400
Mailing Address - Fax:715-832-4187
Practice Address - Street 1:1200 OAKLEAF WAY
Practice Address - Street 2:SUITE A
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-2245
Practice Address - Country:US
Practice Address - Phone:715-832-1400
Practice Address - Fax:715-832-4187
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2021-12-17
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Provider Licenses
StateLicense IDTaxonomies
WI54260-020207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery