Provider Demographics
NPI:1235556481
Name:KARSTEN, MIKELL BRETT (MD)
Entity Type:Individual
Prefix:DR
First Name:MIKELL
Middle Name:BRETT
Last Name:KARSTEN
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 1:5390 E ERICKSON DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2822
Mailing Address - Country:US
Mailing Address - Phone:520-733-2250
Mailing Address - Fax:
Practice Address - Street 1:1412 PLUNKET RD
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:GA
Practice Address - Zip Code:31091-5600
Practice Address - Country:US
Practice Address - Phone:478-627-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55130208D00000X
GA91885208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice