Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 46387 | TN |
N | 207R00000X | Internist | 46387 | TN |
N | 111NI0900X | Internist | 46387 | TN |
NPI | 1114134863 |
---|---|
Provider Name | Dr. Karen Ashmore Maltby |
First Address | Tupelo, MS 38801-5748 |
Second Address | Tupelo, MS 38801-5748 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 20/06/2013 |