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NPI Code Detail

MEDICARE: DR. KAREN M SMALL MD

MEDICARE: DR. KAREN M SMALL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician22602KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457352957
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAREN M SMALL MD
Provider Business Mailing Address
First Line : 310 N L ROGERS WELLS BLVD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1300
Country : US
Telephone Number : 270-651-1111
Fax Number : 270-659-5851
Provider Business Practice Location Address
First Line : 310 N L ROGERS WELLS BLVD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1300
Country : US
Telephone Number : 270-651-1111
Fax Number : 270-659-5851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 09/18/2014

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