Russell Martin Carlson DPM

NPI 1023271137 - Podiatrist - 213ES0103X

NPI Details
NPI 1023271137
Gender Male
Enumeration Date 07/08/2008
Last Updated 05/06/2013
Entity Type Individual
Active Over 8 years ago
Practice Location
520 VALLEY VIEW DR
MOLINE IL, 61265-6152, US
Phone (309) 762-3621
Fax (309) 762-3690
Business Location
520 VALLEY VIEW DR
MOLINE IL, 61265-6152, US
Phone (309) 762-3621
Fax (309) 762-3690
Toxanomy
Taxonomy Code 213ES0103X
License State Illinois
License Number 135000650
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According to our database, Dr. Russell Martin Carlson DPM NPI is 1023271137, taxonomy code is 213ES0103X and license number is 135000650, license state is located at Illinois. Russell Martin Carlson DPM physically located at 520 Valley View Dr, Moline IL, 61265-6152. NPI Number Russell Martin Carlson DPM has the Individual type.

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1023271137 NPI number is provided on an as is basis without warranty of any kind. 1023271137 is maintained by the National Plan & Provider Enumeration System. The contents of Russell Martin Carlson DPM are for informational purposes only.