Provider Demographics
NPI:1326159120
Name:HANSEN, KARLA K (MD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:K
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3205 SHRINE ROAD
Mailing Address - Street 2:SUITE 480
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4722
Mailing Address - Country:US
Mailing Address - Phone:912-466-7280
Mailing Address - Fax:912-466-7293
Practice Address - Street 1:2500 STARLING STREET
Practice Address - Street 2:SUITE 601
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4271
Practice Address - Country:US
Practice Address - Phone:912-466-5640
Practice Address - Fax:912-466-5643
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD048635L207Y00000X
GA50633207YX0905X
GA050633207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology