Provider Demographics
NPI:1497782197
Name:MCALEESE, KARL J (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:J
Last Name:MCALEESE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2475 N PARK DR
Mailing Address - Street 2:STE 10
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-2200
Mailing Address - Country:US
Mailing Address - Phone:812-376-9261
Mailing Address - Fax:812-378-9518
Practice Address - Street 1:2475 N PARK DR
Practice Address - Street 2:STE 10
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-2200
Practice Address - Country:US
Practice Address - Phone:812-376-9261
Practice Address - Fax:812-378-9518
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01027821208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN183650AMedicare PIN
INB28111Medicare UPIN