Provider Demographics
NPI:1114977840
Name:HERBST, KAREN LOUISE (PHD, MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LOUISE
Last Name:HERBST
Suffix:
Gender:F
Credentials:PHD, MD
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Mailing Address - Street 1:6365 E TANQUE VERDE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3830
Mailing Address - Country:US
Mailing Address - Phone:310-882-5454
Mailing Address - Fax:310-747-5908
Practice Address - Street 1:6365 E TANQUE VERDE RD STE 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3830
Practice Address - Country:US
Practice Address - Phone:310-882-5454
Practice Address - Fax:310-882-5454
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA80165207RE0101X
AZ47835207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1114977840OtherNPI