Dr JACK V CARLISLE is a male medical professional, specializing in Family Medicine. He graduated in 1987 from Rush Medical College Of Rush University.
GRAND ITASCA CLINIC AND HOSPITAL
111 SE 3RD ST
GRAND RAPIDS
MN
557443663
Tel: 2183263401
| Npi | 1326023060 |
| Pac Id | 0244142412 |
| Professional Enrollment Id | I20080304000641 |
| Last Name | CARLISLE |
| First Name | JACK |
| Middle Name | V |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY |
| Graduation Year | 1987 |
| Primary Specialty | FAMILY MEDICINE |
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| Organization Legal Name | GRAND ITASCA CLINIC AND HOSPITAL |
| Group Practice Pac Id | 8123939550 |
| Number Of Group Practice Members | 74 |
| Line 1 Street Address | 111 SE 3RD ST |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 557443663 |
| Phone Number | 2183263401 |
| Hospital Affiliation Ccn 1 | 240064 |
| Hospital Affiliation Lbn 1 | GRAND ITASCA CLINIC AND HOSPITAL |
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| Professional Accepts Medicare Assignment | Y |
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