Provider Demographics
NPI:1407896871
Name:GOLNIK, KARL C (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:C
Last Name:GOLNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4445 LAKE FOREST DR
Mailing Address - Street 2:STE 600
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3744
Mailing Address - Country:US
Mailing Address - Phone:513-569-3741
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:1945 CEI DRIVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-3311
Practice Address - Country:US
Practice Address - Phone:513-569-3741
Practice Address - Fax:513-569-3941
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066302207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64935612Medicaid
OH180026055OtherRAILROAD MEDICARE
IN20074380Medicaid
000000020951OtherBCBS
OH0979900Medicaid
31.1473421OtherTAX ID
IN20074380Medicaid
OH0758155Medicare PIN
E42045Medicare UPIN
OH0979900Medicaid