MARK LUTHER CARLSON (NPI# 1528192150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528192150 |
| Entity Type | Individual |
| Full Name | MARK LUTHER CARLSON |
| Credential | M.D. |
| Practice Address |
1423 N Jefferson Ave Springfield MO 65802-1917 |
| Practice Telephone | 4172692273 |
| Practice Fax Number | 4172698851 |
| Mailing Telephone | 4172692273 |
| Mailing Fax Number | 4172698851 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2018-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
101949 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861935082 | Mark Andrew Carlson | Contractor | 29822 Windwood Cir, Temecula, CA 92591-2807 | 2016-11-19 |
| 1265661243 | Mark Frederick Carlson | Speech-Language Pathologist | 1603 Ne 52nd Ave, Portland, OR 97213-2725 | 2009-07-10 |
| 1205095759 | Mark Kent Carlson | Chiropractor | 9437 Ironwood Dr, Frisco, TX 75034-1254 | 2008-06-09 |
| 1851449318 | Mark A. Carlson | Family Medicine | 1400 E. Kincade Street, Mount Vernon, WA 98274-4127 | 2007-01-08 |
| 1184736498 | Mark D Carlson | Internal Medicine | 2401 S Tucker Ave Ste 1, Pittsburg, KS 66762-6619 | 2006-08-31 |
| 1790741049 | Mark Edwin Carlson | Specialist | 1848 Daimler Rd, Rockford, IL 61112-1019 | 2006-04-25 |
| 1083670780 | Mark David Carlson | Dentist | 1550 South Union Avenue, Suite 250, Tacoma, WA 98405-1946 | 2006-04-22 |
| 1609837368 | Mark O. Carlson | Internal Medicine | 1605 Douglas St, Sioux City, IA 51105-1109 | 2006-03-31 |
| 1023008398 | Mark D Carlson | Family Medicine | 1905 S Lakeline Blvd Ste 4, Cedar Park, TX 78613 | 2005-10-26 |
| 1801437694 | Mark Carlson | Chiropractor | 2377 Cumberland Square Dr, Bettendorf, IA 52722-3251 | 2019-10-02 |
| Street Address |
1423 N JEFFERSON AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65802-1917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004605 | Laird E. Jones | Psychiatry & Neurology | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2005-06-27 |
| 1396367264 | Brandon Allen Lane | Physical Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2020-05-13 |
| 1881215119 | Brenda Lea Stevens-ricci | Occupational Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1988 | 2020-04-28 |
| 1386263861 | Matthew A Murphy | Physical Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1988 | 2020-04-14 |
| 1790304277 | Phillip Wayne Goble | Physical Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2020-04-14 |
| 1568017150 | Sara Perry | Speech-Language Pathologist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2019-08-09 |
| 1790330074 | Journey Mccarty | Pharmacist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2019-08-05 |
| 1184180374 | Andrea James | Physician Assistant | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2019-02-13 |
| 1376036954 | Rebekah Elizabeth Pierce | Nurse Practitioner | 1423 N Jefferson Ave, Springfield, MO 65802-1988 | 2018-06-08 |
| 1477043263 | Christy Deann Laye | Nurse Practitioner | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2018-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
| 1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
| 1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
| Find all providers in zip 65802 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548519614 | Carlene Westfall | Internal Medicine | 201 N Yellow Springs St, Springfield, OH 45504-2650 | 2012-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669540928 | Daniel Paul Windsor | Internal Medicine | 910 Brookwood Ctr, Fenton, MO 63026-3474 | 2006-12-02 |
| 1740436971 | Jorge F Kawano-castillo | Internal Medicine | 2301 Holmes St, Kansas City, MO 64108-2640 | 2008-08-07 |
| City | SPRINGFIELD |
| Zip Code | 65802 |
Please comment or provide details below to improve the information on MARK LUTHER CARLSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.