Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036.135934 | IL |
N | 207Q00000X | Family Doctor | DO.000439 | LA |
Y | 207QS0010X | Family Doctor - Sports Medicine | DO.000439 | LA |
NPI | 1245595040 |
---|---|
Provider Name | Dr. Donald C. Carson |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70808-4333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2012 |
Last Update Date | 19/02/2020 |