Healthcare Provider Details

I. General information

NPI: 1205912425
Provider Name (Legal Business Name): KAREN ELIZABETH STARRETT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N MAIN ST STE 210
SPRINGBORO OH
45066-2100
US

IV. Provider business mailing address

1 PRESTIGE PL STE 550
MIAMISBURG OH
45342-6115
US

V. Phone/Fax

Practice location:
  • Phone: 937-762-5500
  • Fax: 937-762-5099
Mailing address:
  • Phone: 937-762-1310
  • Fax: 937-522-8068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35077371
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2007228
Identifier TypeOTHER
Identifier State
Identifier IssuerUNITED HEALTH CARE
# 2
Identifier7552149
Identifier TypeOTHER
Identifier StateOH
Identifier IssuerAETNA
# 3
Identifier2262135
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer
# 4
Identifier2262135
Identifier TypeOTHER
Identifier State
Identifier IssuerBCMH
# 5
Identifier000000546684
Identifier TypeOTHER
Identifier State
Identifier IssuerANTHEM
# 6
Identifier522374873032
Identifier TypeOTHER
Identifier State
Identifier IssuerCARESOURCE
# 7
Identifier5430945-007
Identifier TypeOTHER
Identifier State
Identifier IssuerCIGNA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: