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NPI Code Detail

MEDICARE: DR. JERRY KARR DO

MEDICARE:  DR. JERRY  KARR  DO
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
1146N00000XBasic Emergency Medical Technician03217IA
2207P00000XEmergency Medicine Physician101878MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00889535OTHERMORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
249428OTHERIABX
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4930097243OTHERIARRMC

General Provider Information

NPI Number : 1174505481
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JERRY KARR DO
Provider Business Mailing Address
First Line : PO BOX 18057B
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63150-8057
Country : US
Telephone Number : 636-239-8011
Fax Number : 636-390-7296
Provider Business Practice Location Address
First Line : 901 E 5TH ST
Second Line :
City : WASHINGTON
State : MO
Zip : 63090-3127
Country : US
Telephone Number : 636-239-8011
Fax Number : 636-390-7296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 03/12/2015

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