Provider Demographics
NPI:1346230760
Name:HEIDEN, KAREN D (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:D
Last Name:HEIDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2200 PARK AVE BLDG D
Mailing Address - Street 2:STE 100
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-7246
Mailing Address - Country:US
Mailing Address - Phone:435-615-8822
Mailing Address - Fax:435-615-8823
Practice Address - Street 1:2200 PARK AVE BLDG D
Practice Address - Street 2:STE 100
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7246
Practice Address - Country:US
Practice Address - Phone:435-615-8822
Practice Address - Fax:435-615-8823
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA602420207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A602420Medicaid
CA00A602420Medicaid
CAG92845Medicare UPIN