Provider Demographics
NPI:1528055688
Name:CARLSON, KAREN ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELAINE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ELAINE
Other - Last Name:PFEISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1111 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5793
Mailing Address - Country:US
Mailing Address - Phone:515-239-4431
Mailing Address - Fax:515-239-3644
Practice Address - Street 1:1111 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5793
Practice Address - Country:US
Practice Address - Phone:515-239-4431
Practice Address - Fax:515-239-3644
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA31131208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2078535Medicaid
IA17849Medicare ID - Type Unspecified
IAD48397Medicare UPIN