Healthcare Provider Details

I. General information

NPI: 1306870951
Provider Name (Legal Business Name): KAREN G. HYATT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN G. GLADDEN MD

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 59TH ST
VIRGINIA BEACH VA
23451-2261
US

IV. Provider business mailing address

4750 MEXICO RD
SAINT PETERS MO
63376-1663
US

V. Phone/Fax

Practice location:
  • Phone: 636-498-4555
  • Fax:
Mailing address:
  • Phone: 636-498-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number0101055288
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number57186
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number57186
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number118237
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: