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Provider Information for 1760618508

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

CHRIS CARSON M.D.

Gender: MALE

Individual NPI: 1760618508

Calendar   Last Updated:  2016-05-09
  Certification Date: 

Details

Name Value
NPI 1760618508
Enumeration Date 2009-06-08
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 61 DOLPHIN DR
TREASURE ISLAND, FL 33706-3113
United States

Phone: 727-954-0671 | Fax: 727-825-1354
View Map External Link
Primary Practice Address 61 DOLPHIN DR
TREASURE ISLAND, FL 33706-3113
United States

Phone: 727-954-0671 | Fax: 727-825-1354
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 006606000
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME112823
No 207R00000X - Internal Medicine FL TRN13804