MEDICARE: DR. KAREN RENEE MELTON AU.D.

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
1	231H00000X	Audiologist	113484	MO
2	237600000X	Audiologist-Hearing Aid Fitter	001230	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200216286 63640 0000	OTHER	MO	TRI-CARE
2	200216286AUD	OTHER	MO	MERCY
3	621859	OTHER	MO	HEALTHLINK
4	7035519	OTHER	MO	AETNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	20-0216286	OTHER	MO	GM
7	45-00144	OTHER	MO	UHC
8	193973	OTHER	MO	BCBS

General Provider Information

NPI Number	:	1366451916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN RENEE MELTON AU.D.

Provider Business Mailing Address
First Line	:	620 WALTON DR
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-1935
Country	:	US
Telephone Number	:	573-756-0500
Fax Number	:	573-756-0505

Provider Business Practice Location Address
First Line	:	620 WALTON DR
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-1981
Country	:	US
Telephone Number	:	573-756-0500
Fax Number	:	573-756-0505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	11/20/2014

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