Doctor Name: | LINN HAZE CARLETON |
NPI Number: | 1487698395 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | OS-003570-L |
Business Practice Address: | 2642 E Ontario St Philadelphia, PA - 191345338 |
Business Phone Number: | 2154252133 |
Business Fax Number: | |
Mailing Address: | 2642 E Ontario St, PHILADELPHIA |
State: | PA |
Postal Code: | 191345338 |
Phone Number: | 2672548553 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS-003570-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |