MEDICARE: DR. KAREN C PANZITTA M.D.

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
1	2085B0100X	Body Imaging Physician	38446	GA
2	2085U0001X	Diagnostic Ultrasound Physician	38446	GA
3	2085R0202X	Diagnostic Radiology Physician	038446	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	591320	OTHER	GA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1588666739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN C PANZITTA M.D.

Provider Business Mailing Address
First Line	:	1120 15TH ST
Second Line	:	GEORGIA REGENTS MEDICAL ASSOCIATES
City	:	AUGUSTA
State	:	GA
Zip	:	30912-0004
Country	:	US
Telephone Number	:	706-721-9729
Fax Number	:	706-721-8507

Provider Business Practice Location Address
First Line	:	1499 WALTON WAY STE 1400
Second Line	:	PHYSICIANS PRACTICE GROUP
City	:	AUGUSTA
State	:	GA
Zip	:	30901-2603
Country	:	US
Telephone Number	:	706-724-6100
Fax Number	:	706-724-1600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	09/27/2013

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Directions to “ DR. KAREN C PANZITTA M.D.” Practice Location

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