Provider Demographics
NPI:1467466110
Name:MCNAIR, KARLA A (MD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:A
Last Name:MCNAIR
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 1:2525 SOUTHEAST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-3464
Mailing Address - Country:US
Mailing Address - Phone:330-332-2710
Mailing Address - Fax:330-332-2725
Practice Address - Street 1:1076 E STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2228
Practice Address - Country:US
Practice Address - Phone:330-332-2710
Practice Address - Fax:330-332-2725
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074154208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2117720Medicaid
OH2117720Medicaid