Provider Demographics
NPI:1154306538
Name:PECHT, KARL RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:RICHARD
Last Name:PECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:104 BRICKLEY DRIVE
Mailing Address - City:BLANCHARD
Mailing Address - State:PA
Mailing Address - Zip Code:16826-0215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 BRICKLEY DRIVE
Practice Address - Street 2:ROUTE 150
Practice Address - City:BLANCHARD
Practice Address - State:PA
Practice Address - Zip Code:16826-0215
Practice Address - Country:US
Practice Address - Phone:570-962-2116
Practice Address - Fax:570-962-6425
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027599E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008697790001Medicaid
PA0008697790001Medicaid
PA115085Medicare PIN