Provider Demographics
NPI:1881858827
Name:MC SLEEP, PC
Entity Type:Organization
Organization Name:MC SLEEP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SECRETARY/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTEN
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-745-3955
Mailing Address - Street 1:1168 DUTTON CT
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-5301
Mailing Address - Country:US
Mailing Address - Phone:307-745-3955
Mailing Address - Fax:
Practice Address - Street 1:1168 DUTTON CT
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-5301
Practice Address - Country:US
Practice Address - Phone:307-745-3955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5392A261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic