Provider Demographics
NPI:1548552508
Name:EMERSON, CAROLYN MOHR (MD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MOHR
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:CAROLYN
Other - Last Name:MOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2754 COMPASS DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8714
Mailing Address - Country:US
Mailing Address - Phone:970-254-1686
Mailing Address - Fax:
Practice Address - Street 1:2021 N 12TH ST
Practice Address - Street 2:SUITE 170
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2980
Practice Address - Country:US
Practice Address - Phone:970-254-1686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55259207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology