Provider Demographics
NPI:1376620690
Name:KARR AND KORNBERG ORTHOPAEDIC ASSOCIATES, MD, PA
Entity Type:Organization
Organization Name:KARR AND KORNBERG ORTHOPAEDIC ASSOCIATES, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARKUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KORNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-846-6004
Mailing Address - Street 1:604 OAK COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4198
Mailing Address - Country:US
Mailing Address - Phone:407-846-6004
Mailing Address - Fax:407-846-1422
Practice Address - Street 1:604 OAK COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4198
Practice Address - Country:US
Practice Address - Phone:407-846-6004
Practice Address - Fax:407-846-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0729250001OtherRAILROAD
FL0729250001OtherRAILROAD
FL0729250001Medicare PIN
FL0729250001Medicare NSC