Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036.124.557 | IL |
N | 208600000X | Surgeon | 036.124.557 | IL |
Y | 2086S0120X | Pediatric Surgery | MD-43379 | IA |
NPI | 1649508037 |
---|---|
Provider Name | Dr. Erica M Carlisle |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2009 |
Last Update Date | 10/08/2016 |