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KENNETH MICHAEL CARLSON MD NPI 1952332702


NPI Information

NPI: 1952332702
Provider Name: KENNETH MICHAEL CARLSON, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
121 SE VIEWMONT AVE
CORVALLIS, OR
ZIP 97333
Phone: (541) 766-3546
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Kenneth Michael Carlson, MD is a pediatrics in Corvallis, OR. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Kenneth Michael Carlson, MD NPI is 1952332702. 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:

121 SE VIEWMONT AVE
CORVALLIS, OR
ZIP 97333-968
Phone: (541) 766-3546
Fax: (541) 766-6143

The enumeration date for this NPI number is 7/6/2006 and was last updated on 8/30/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsMD22868OREGONYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1287244MEDICAIDOREGON

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.