Provider Demographics
NPI:1376694679
Name:FALK, KARL J (DO)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:J
Last Name:FALK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE LECOM PLACE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-2571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:814-868-2522
Practice Address - Street 1:2010 W 38TH ST UPPR LVL
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2004
Practice Address - Country:US
Practice Address - Phone:814-866-6835
Practice Address - Fax:814-866-6837
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006374207Q00000X
PA0S006325L204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011813680020Medicaid
PA0011813680006Medicaid
PA0011813680001Medicaid
PA0011813680001Medicaid