Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 7281 | KY |
Y | 1223G0001X | General Practice | 7281 | KY |
Y | 213EG0000X | General Practice | 7281 | KY |
NPI | 1235278847 |
---|---|
Provider Name | Dr. Tamara White Karelis |
First Address | Hazard, KY 41701-9485 |
Second Address | Hazard, KY 41701-1920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 29/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
45002227 | (05) | KY |
60001609 | (05) | KY |