Provider Demographics
NPI:1659300275
Name:KING, KAREN GUSS (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GUSS
Last Name:KING
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 1:3841 TRUEMAN CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026
Mailing Address - Country:US
Mailing Address - Phone:614-777-4801
Mailing Address - Fax:614-777-8644
Practice Address - Street 1:3841 TRUEMAN CT
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026
Practice Address - Country:US
Practice Address - Phone:614-777-4801
Practice Address - Fax:614-777-3844
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059713K207V00000X
OH35059713207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
K10717143Medicare PIN
F28086Medicare UPIN
MI 0717143Medicare ID - Type Unspecified