Provider Demographics
NPI:1629576079
Name:KARR, ERIC R (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:R
Last Name:KARR
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 1:4881 SUGAR MAPLE DR
Mailing Address - Street 2:INTERNAL MEDICINE CLINIC A
Mailing Address - City:WRIGHT PATTERSON AFB
Mailing Address - State:OH
Mailing Address - Zip Code:45433
Mailing Address - Country:US
Mailing Address - Phone:937-257-2432
Mailing Address - Fax:937-696-3696
Practice Address - Street 1:4881 SUGAR MAPLE DR
Practice Address - Street 2:INTERNAL MEDICINE CLINIC A
Practice Address - City:WRIGHT PATTERSON AFB
Practice Address - State:OH
Practice Address - Zip Code:45433-5529
Practice Address - Country:US
Practice Address - Phone:937-522-2778
Practice Address - Fax:937-696-3696
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014087207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0301669Medicaid