Provider Demographics
NPI:1679505598
Name:CHASE, KAREN M (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:CHASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3805 MCCAIN PARK DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7803
Mailing Address - Country:US
Mailing Address - Phone:719-688-4845
Mailing Address - Fax:
Practice Address - Street 1:3805 MCCAIN PARK DR
Practice Address - Street 2:SUITE 112
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7803
Practice Address - Country:US
Practice Address - Phone:719-688-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY215401207Q00000X
CO39244207Q00000X
LA206622207Q00000X
ARE9671207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68031882Medicaid
CO68031882Medicaid
CO68031882Medicaid