Provider Demographics
NPI:1255479515
Name:OKELLY, KAREN RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:RUTH
Last Name:OKELLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 N STATE ROAD 19
Mailing Address - Street 2:SUITE 48
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-2482
Mailing Address - Country:US
Mailing Address - Phone:386-329-8800
Mailing Address - Fax:386-329-8805
Practice Address - Street 1:400 N STATE ROAD 19
Practice Address - Street 2:SUITE 48
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-2482
Practice Address - Country:US
Practice Address - Phone:386-329-8800
Practice Address - Fax:386-329-8805
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD409282084P0800X
TN40928207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine