Provider Demographics
NPI:1639168792
Name:PAUL, KAREN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:PAUL
Other - Last Name:HOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 56072
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70055-6072
Mailing Address - Country:US
Mailing Address - Phone:504-346-3642
Mailing Address - Fax:504-265-9439
Practice Address - Street 1:42024 HIGHWAY 195
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-7054
Practice Address - Country:US
Practice Address - Phone:205-486-5213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201184208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0447839Medicaid
LA0447839Medicaid
LAH52870Medicare UPIN