Provider Demographics
NPI:1134173974
Name:CARLSON, JOANNA ARCUNI (MD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:ARCUNI
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:PRESCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11995 SINGLETREE LN
Mailing Address - Street 2:STE 500
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-5347
Mailing Address - Country:US
Mailing Address - Phone:952-595-1301
Mailing Address - Fax:612-294-4903
Practice Address - Street 1:17585 75TH AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-2409
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN598682085R0202X
WAMD000451772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8882204OtherPTAN-TRA PIERCE CO
WAG8882205OtherPTAN-TRA KING CO
WA0252379OtherLABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
WA8427387Medicaid
WA0252372OtherLABOR AND INDUSTRIES-UNION AVENUE OPEN MRI
WA0250650OtherLABOR AND INDUSTRIES-TRA LILLY
WAI24780Medicare UPIN
WAG8883545OtherPTAN-MIO1
WAG8883927OtherPTAN-UAOM
WA8854789Medicare ID - Type Unspecified