Provider Demographics
NPI:1669446100
Name:JAHNKE, KAREN A (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:JAHNKE
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 1:301 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-2471
Mailing Address - Country:US
Mailing Address - Phone:903-641-4800
Mailing Address - Fax:903-641-4822
Practice Address - Street 1:400 HOSPITAL DR
Practice Address - Street 2:SUITE 208
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2489
Practice Address - Country:US
Practice Address - Phone:903-641-4800
Practice Address - Fax:903-641-4822
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1482208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121233404Medicaid
TX121233406Medicaid
TX8W4548OtherBLUE CROSS
TX8D6431Medicare PIN
G32563Medicare UPIN
TX121233404Medicaid