| Doctor Name: | SCOTT J CARLSON |
| NPI Number: | 1700959632 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01049196A |
| Business Practice Address: | 1721 Taussig Norfolk, VA - 23511 |
| Business Phone Number: | 7579538868 |
| Business Fax Number: | |
| Mailing Address: | 1454 Dory Dr, Apt 1848 VIRGINIA BEACH |
| State: | VA |
| Postal Code: | 234535651 |
| Phone Number: | 7579538868 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01049196A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |