Provider Demographics
NPI:1073547998
Name:DR. JOEL P KARASEK MD PC
Entity Type:Organization
Organization Name:DR. JOEL P KARASEK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:KARASEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-232-6601
Mailing Address - Street 1:3955 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3649
Mailing Address - Country:US
Mailing Address - Phone:816-232-6601
Mailing Address - Fax:816-232-6606
Practice Address - Street 1:3955 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3649
Practice Address - Country:US
Practice Address - Phone:816-232-6601
Practice Address - Fax:816-232-6606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO28364059OtherBLUE CROSS BLUE SHIELD
MO206948622Medicaid