Provider Demographics
NPI:1235319666
Name:MICHAEL KARASEK, MD,PC
Entity Type:Organization
Organization Name:MICHAEL KARASEK, MD,PC
Other - Org Name:NORTHWEST SPINE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KARASEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-345-9800
Mailing Address - Street 1:689 E 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4304
Mailing Address - Country:US
Mailing Address - Phone:541-345-9800
Mailing Address - Fax:541-683-3167
Practice Address - Street 1:689 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4304
Practice Address - Country:US
Practice Address - Phone:541-345-9800
Practice Address - Fax:541-683-3167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10955208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR100967Medicare PIN