Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 1001125-15 | WI |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DRPM2328 | FL |
NPI | 1043697543 |
---|---|
Provider Name | Dr. Joseph Robert Karlen |
First Address | Sussex, WI 53089-4123 |
Second Address | Gainesville, FL 32610-0416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2015 |
Last Update Date | 11/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DRPM2328 | FLORIDA DENTAL RESIDENT PERMIT (01) | FL |