DR. ROBERT LEE CARLSON JR. (NPI# 1710030002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710030002 |
Entity Type | Individual |
Full Name | DR. ROBERT LEE CARLSON JR. |
Credential | M.D. |
Practice Address |
3900 Legacy Park Blvd Nw Suite C-100 Kennesaw GA 30144-7412 |
Mailing Address |
3970 Bellingrath Main Nw Kennesaw GA 30144-6020 |
Practice Telephone | 6787976277 |
Practice Fax Number | 6787976278 |
Mailing Telephone | 7707941157 |
Mailing Fax Number | 6787976278 |
Enumeration Date | 2007-01-19 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
043890 | GA | Allopathic & Osteopathic Physicians |
X | 207PE0005X |
Emergency Medicine Specialization: Undersea and Hyperbaric Medicine |
043890 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 00770459C | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174981344 | Robert Carlson | Counselor | 6180 Lehman Dr Ste 205, Colorado Springs, CO 80918-3459 | 2016-02-03 |
1790003515 | Robert Shaun Carlson | Physical Therapist | 884 Loblolly Dr, Vass, NC 28396 | 2010-05-05 |
1518289438 | Robert Carlson | Family Medicine | 10813 Portobelo Dr, San Diego, CA 92124-1121 | 2010-02-19 |
1659524379 | Robert Henry Carlson IIi | General Practice | 5454 Overton Rd, Birmingham, AL 35210-4103 | 2008-10-25 |
1922257047 | Robert Henry Carlson | Dentist | 435 W Landis Ave, Vineland, NJ 08360-8105 | 2008-09-12 |
1811058399 | Robert T. Carlson | Optometrist | 357 W Army Trail Rd, #32, Bloomingdale, IL 60108-2357 | 2006-12-12 |
1750494498 | Robert Bruce Carlson | Dentist | 220 Sunbird Cliffs Ln, Colorado Springs, CO 80919-8015 | 2006-08-16 |
1871567198 | Robert A Carlson Jr. | Optometrist | Ihs Optometry Clinic, 317 Main Street, Eagle Butte, SD 57625 | 2006-02-14 |
1013900174 | Robert D Carlson | Family Medicine | 47 E Main St, Stafford Springs, CT 06076-1227 | 2005-08-24 |
1235786591 | Robert Carlson | Counselor | 200 Cordwainer Dr Ste 200, Norwell, MA 02061-1671 | 2019-08-21 |
Street Address |
3900 LEGACY PARK BLVD NW SUITE C-100 |
City | KENNESAW |
State | GA |
Zip Code | 30144-7412 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619483328 | Dr. Michelle Oz LLC D/b/a Momentum Chiropractic | Chiropractor | 3900 Legacy Park Blvd Nw, Kennesaw, GA 30144-7412 | 2017-12-18 |
1255728580 | Dream Body, Inc | Specialist/Technologist | 3900 Legacy Park Blvd Nw, D-400, Kennesaw, GA 30144-7412 | 2015-04-24 |
1477890945 | Atlas First LLC | Chiropractor | 3900 Legacy Park Blvd Nw, Suite C100, Kennesaw, GA 30144-7412 | 2013-01-03 |
1467621375 | Dunham Medical LLC | Durable Medical Equipment & Medical Supplies | 3900 Legacy Park Blvd Nw, D-300, Kennesaw, GA 30144-7412 | 2008-02-25 |
1891812251 | Legacy Dental Care PC | Dentist | 3900 Legacy Park Blvd Nw, Suite D-100, Kennesaw, GA 30144-7412 | 2007-03-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
Find all providers in zip 30144 |
Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629143227 | Tiffani Leigh Salas | Emergency Medicine | 750 Town Park Lane, Kennesaw, GA 30144 | 2006-11-21 |
1821196866 | Brian Patrick Mason | Emergency Medicine | 750 Town Park Lane, Town Park Comprehensive Medical Center, Kennesaw, GA 30114 | 2006-09-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528675956 | Nextgen Ems LLC | Emergency Medicine | 121 Tyre Dr, Mcdonough, GA 30253-8542 | 2020-09-29 |
1710506233 | Rita Udom | Emergency Medicine | 2795 Davis Rd, Marietta, GA 30062-6670 | 2020-04-14 |
1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
1831539253 | Andrew Wesley White | Emergency Medicine | 1120 15th St # Af1006, Augusta, GA 30912-4500 | 2013-06-29 |
1013141118 | Darren Deandre Naugles | Emergency Medicine | 8920 Firestone Cir, Duluth, GA 30097-6627 | 2009-05-05 |
1437393667 | Donald R. Dalbey | Emergency Medicine | 3725 Sweetwater Drive, Cumming, GA 30041 | 2009-05-01 |
1346411667 | Harvey E Schuck | Emergency Medicine | 427 Brentwood Dr Ne, Atlanta, GA 30305-3204 | 2008-03-14 |
1639364011 | Srihari Rao Malempati | Emergency Medicine | 535 Trimble Lake Ct Ne, Atlanta, GA 30342-2481 | 2007-09-10 |
1306060264 | Gary L Godlewski | Emergency Medicine | 4755 Wesleyan Woods Dr, Macon, GA 31210-4410 | 2007-04-12 |
1487729992 | Lisa Tadayon | Emergency Medicine | 1000 John Fy Rd Ne, Atlanta, GA 30342-1606 | 2006-11-21 |
Find all providers with the same taxonomy |
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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.