Provider Demographics
NPI:1518185487
Name:CANLAS, KAREN R (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:CANLAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-450-6815
Mailing Address - Fax:812-450-6822
Practice Address - Street 1:340 STARLITE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-6102
Practice Address - Country:US
Practice Address - Phone:270-844-8027
Practice Address - Fax:270-844-8183
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01066149A207RG0100X
KY38601207RG0100X, 207RG0100X
NC2005-01298207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100066440Medicaid
KYK000782Medicare PIN