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OIG exclusion detail

RAY CARLSON

This page shows an imported LEIE row. Verify details against the official OIG source before acting.

Imported OIG rowOfficial OIG source
NPI
1114077468
Name
RAY LYNN CARLSON
Address
2743 W PEAK CLOUD LN, UNIT A41, MERIDIAN, ID, 83642
Specialty
EMERGENCY MEDICINE
Exclusion type
1128a1
Exclusion date
20250619
Reinstatement date
00000000
Waiver
00000000

Source snapshot

Imported: May 05, 2026

Rows: 83,001

Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7

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