Provider Demographics
NPI:1083605133
Name:KARPOVS, ANATOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANATOLE
Middle Name:
Last Name:KARPOVS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 VOGUE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-8505
Mailing Address - Country:US
Mailing Address - Phone:337-474-1470
Mailing Address - Fax:
Practice Address - Street 1:2903 1ST AVE
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8809
Practice Address - Country:US
Practice Address - Phone:337-478-6480
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200155208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1625591Medicaid
I13644Medicare UPIN
005058M93Medicare ID - Type Unspecified