Provider Demographics
NPI:1306835020
Name:GARBY, KAREN B (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:B
Last Name:GARBY
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 1:1457 W SOUTHERN AVE
Mailing Address - Street 2:SUITE 26
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4813
Mailing Address - Country:US
Mailing Address - Phone:480-374-7354
Mailing Address - Fax:480-371-1121
Practice Address - Street 1:1457 W SOUTHERN AVE
Practice Address - Street 2:SUITE 26
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4813
Practice Address - Country:US
Practice Address - Phone:480-374-7354
Practice Address - Fax:480-371-1121
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ253772085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ385494Medicaid
G47479Medicare UPIN
AZ385494Medicaid
WCKJY29Medicare ID - Type UnspecifiedEVDI
AZ385494Medicaid