Provider Demographics
NPI:1366451478
Name:KARP, DEBORAH R (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:KARP
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 1:148 BILL CARRUTH PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-3756
Mailing Address - Country:US
Mailing Address - Phone:470-956-4050
Mailing Address - Fax:
Practice Address - Street 1:148 BILL CARRUTH PKWY STE 260
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3756
Practice Address - Country:US
Practice Address - Phone:470-956-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100715207VG0400X
IN01061081A207VG0400X
GA66127207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200528590AMedicaid
IN151020UUMedicare ID - Type Unspecified
IN200528590AMedicaid