Healthcare Provider Details

I. General information

NPI: 1891967758
Provider Name (Legal Business Name): KAREN M HONIKEL-MARLETT PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

586 BRANNEN ST
STATESBORO GA
30458-5557
US

IV. Provider business mailing address

610 N WILLIAMSBURG RD
SAVANNAH GA
31419-1022
US

V. Phone/Fax

Practice location:
  • Phone: 912-871-6611
  • Fax:
Mailing address:
  • Phone: 518-229-2408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number7103
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1515
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: