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Contact Information

DEREK C CARLSON, MD
301 E SAINT JOSEPH ST
GREEN BAY, WI54301-2241
 Phone: 920-433-3630
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for DEREK C CARLSON · (Male)

NPI # 1790775450
Status Active
Credentials MD
Entity Individual
Enumeration date 10/25/2005
Last updated 11/23/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301106248
  • WI License # 61608-20
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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