Provider Demographics
NPI:1093701989
Name:KARNAMA, YADOLAH (MD)
Entity Type:Individual
Prefix:MR
First Name:YADOLAH
Middle Name:
Last Name:KARNAMA
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 1:1223 S GEAR AVENUE SUITE 207
Mailing Address - Street 2:
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1693
Mailing Address - Country:US
Mailing Address - Phone:319-752-8424
Mailing Address - Fax:319-752-7327
Practice Address - Street 1:1223 S GEAR AVENUE SUITE 207
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1693
Practice Address - Country:US
Practice Address - Phone:319-752-8424
Practice Address - Fax:319-752-7327
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA26392156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0258343Medicaid
1167440001Medicare NSC
25834Medicare PIN
IA0258343Medicaid