Active NPI
Glen S Carlson, MD
- Anatomic Pathology Physician
- Atlanta, GA
National Provider Identifier
1710954698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 032149
- Practice address
- 1968 Peachtree Rd NW
Atlanta, GA 30309 - Phone
- (404) 605-3247
- Fax
- (404) 609-6645
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 032149 | GA | Primary |
Addresses
Primary practice location
1968 Peachtree Rd NW
Atlanta, GA 30309
Mailing address
PO Box 491028
Lawrenceville, GA 30049
Phone (404) 605-3247
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032149 | GA | MD | Anatomic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788652800000",
"number": "1710954698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 491028",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30049",
"telephone_number": "404-605-3247",
"fax_number": "404-609-6645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1968 PEACHTREE RD NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30309",
"telephone_number": "404-605-3247",
"fax_number": "404-609-6645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "GLEN",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2026-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "GA",
"license": "032149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.