MEDICARE: KAREN G CORNETT MD PA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1649458696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN G CORNETT MD PA

Provider Business Mailing Address
First Line	:	200 W WINDCREST ST
Second Line	:
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-4408
Country	:	US
Telephone Number	:	830-997-0330
Fax Number	:	830-997-7601

Provider Business Practice Location Address
First Line	:	815 FRONT ST
Second Line	:
City	:	COMFORT
State	:	TX
Zip	:	78013-0156
Country	:	US
Telephone Number	:	830-995-5633
Fax Number	:	830-995-5654

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	KAREN G CORNETT
Credential	:	MD
Telephone Number	:	830-997-0330

Provider Enumeration Date	:	02/01/2008
Last Update Date	:	02/01/2008

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