DR. DOUGLAS W CARLSON MD NPI 1669490132

NPI Information

NPI: 1669490132
Provider Name: DR. DOUGLAS W CARLSON, MD
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
301 N 8TH ST
SUITE PAV4A
SPRINGFIELD, IL
ZIP 62701
Phone: (217) 545-8000
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DR. Douglas W Carlson, MD is a pediatric emergency medicine pediatrics in Springfield, IL. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. DR. Douglas W Carlson, MD NPI is 1669490132. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

301 N 8TH ST
SUITE PAV4A
SPRINGFIELD, IL
ZIP 62701-041
Phone: (217) 545-8000
Fax: (217) 545-2303

The NPI 1669490132 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 9/27/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		036-136399	ILLINOIS	No
2	2080P0204X	Pediatrics	Pediatric Emergency Medicine	036-136399	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	$$$$$$$$$	MEDICAID	ILLINOIS
2	103810102	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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