Carlson, Derek Carl

Carlson, Derek Carl is an individual health care provider with primary practice located at 301 E Saint Joseph St , Green Bay WI 54301-2241. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Carlson, Derek Carl can be contacted via phone (920) 433-3630.

Contact Information

Primary practice address
301 E Saint Joseph St Green Bay WI 54301-2241
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 4301106248 Michigan
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 61608-20 Wisconsin

Profile Details

NPI number 1790775450
LBN Legal business name Carlson, Derek Carl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Nov 23rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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