Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO2590 | FL |
Y | 222Z00000X | Podiatrist | PO2590 | FL |
NPI | 1013988658 |
---|---|
Provider Name | Dr. Jeffrey C Karr |
First Address | Lakeland, FL 33813 |
Second Address | Lakeland, FL 33813 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 31/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01369 | UNIVERSAL (01) | FL |
212764 | AMERIGROUP (01) | FL |
2560434 | AETNA (01) | FL |
U65457 | (02) | FL |