Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2009007996 | MO |
Y | 207Q00000X | Family Doctor | OS006981E | PA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | OS006981E | PA |
NPI | 1194791673 |
---|---|
Provider Name | Jeffrey P Karls |
First Address | Sharon, PA 16146-1503 |
Second Address | Clarion, PA 16214-3882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 09/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012805170009 | (05) | PA |
E36070 | (02) | PA |
P001985 | GATEWAY (01) | PA |
P00716884 | RAILROAD MEDICARE (01) | MO |