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General NPI Number Information
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NPI Number | 1134278187
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Entity Type | Organization
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Legal Business Name | THOMAS KARISNY MD PC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 03/26/2010
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Provider Practice Location Address
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Address Line | 202 HOSPITAL RD
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3139
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Country | US
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Telephone | 706-745-2150
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Fax | 706-745-2053
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Provider Business Mailing Address
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Address Line | 202 HOSPITAL RD
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3134
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Country | US
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Telephone | 706-745-2150
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Fax | 706-745-2053
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NICOLE MARIE KARISNY
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Credential | M.D.
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Telephone | 706-745-1953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 050029
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License Number State | GA
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