Provider Demographics
NPI:1649508037
Name:CARLISLE, ERICA M (MD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:M
Last Name:CARLISLE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:DEPARTMENT OF SURGERY
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-1766
Mailing Address - Fax:319-384-9510
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPARTMENT OF SURGERY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-1766
Practice Address - Fax:319-384-9510
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2016-08-10
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Provider Licenses
StateLicense IDTaxonomies
IL036.124.557208600000X
IAMD-433792086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery