| Robert D. Carlson, M.d. , Llc | |
|
47 E Main St Stafford Springs CT 06076-1227 | |
| (860) 684-5871 | |
| (860) 684-0469 |
| Full Name | Robert D. Carlson, M.d. , Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 47 E Main St, Stafford Springs, Connecticut |
| Authorized Official Name and Position | Robert D Carlson, M.d. , Llc (OWNER/MEMBER) |
| Authorized Official Contact | 8604298439 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert D. Carlson, M.d. , Llc 11 Phelps Way Pob 399 Willington CT 06279 Ph: (860) 429-8439 | Robert D. Carlson, M.d. , Llc 47 E Main St Stafford Springs CT 06076-1227 Ph: (860) 684-5871 |
| NPI Number | 1861718264 |
|---|---|
| Provider Enumeration Date | 04/12/2010 |
| Last Update Date | 01/11/2013 |
| Medicare PECOS PAC ID | 5991820367 |
|---|---|
| Medicare Enrollment ID | O20100909000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861718264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert D Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013900174 PECOS PAC ID: 3274589429 Enrollment ID: I20100909000729 |
Johnson Memorial Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 Chestnut Hill Road, Stafford Springs, CT 06076 Phone: 860-684-4251 |