Provider Demographics
NPI:1205867694
Name:ANTHONY, KAREN DIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DIANE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2838 JANITELL RD E
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4141
Mailing Address - Country:US
Mailing Address - Phone:719-368-7247
Mailing Address - Fax:719-359-5500
Practice Address - Street 1:2838 JANITELL RD E
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4141
Practice Address - Country:US
Practice Address - Phone:719-368-7247
Practice Address - Fax:719-359-5500
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40816207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO30426375Medicaid
CO30426375Medicaid
COC806287Medicare PIN
COP00357921Medicare PIN