Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR009329 | GA |
N | 111NR0200X | Radiology | CHIR009329 | GA |
N | 213ER0200X | Radiology | CHIR009329 | GA |
NPI | 1912311515 |
---|---|
Provider Name | Dr. Ravi Karan |
First Address | Marble Hill, GA 30148-2263 |
Second Address | Marble Hill, GA 30148-2263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2014 |
Last Update Date | 12/06/2014 |