Provider Demographics
NPI:1649407321
Name:HIRSHORN, KARLA ASHLEY (MD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:ASHLEY
Last Name:HIRSHORN
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 1:16 HYLAND RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5756
Mailing Address - Country:US
Mailing Address - Phone:864-586-9798
Mailing Address - Fax:864-587-2855
Practice Address - Street 1:16 HYLAND RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5756
Practice Address - Country:US
Practice Address - Phone:864-586-9798
Practice Address - Fax:864-587-2855
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34598207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC345987Medicaid
SCAA96575453Medicare PIN