John V Carlson, M.D.
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Mexico, MO
NPI 1003874660 · NPPES record last updated Dec 12, 2007
Key facts
- NPI
- 1003874660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- R6C28 (MO)
- Practice address
- 620 E Monroe St
Mexico, MO 65265-2919 - Phone
- (573) 582-8292
- Fax
- (573) 582-3292
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6C28 | MO | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boyce - Bynum Pathology Laboratories, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | R6C28 | MO | Yes |
Addresses
Primary practice location
620 E Monroe St
Mexico, MO 65265-2919
Mailing address
200 Portland St
Columbia, MO 65201-6525
Phone (573) 886-4600
Other providers in Mexico, MO
- Morgan R Campbell
- Jerome Gerongco Canama
- Calvin James Canine
- Virginia J Caputy
- Alyssa Ann Carlisle
- Sharon Parker Carmignani
- Angela Carter
- Center for Digestive & Liver Diseases, Inc.
- Joseph Cherri
- Eugene Arthur Clervi II
All providers in Mexico, MO · Anatomic Pathology & Clinical Pathology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.