Provider Demographics
NPI:1861472748
Name:ANDERSEN, KARLYNA L D (MD)
Entity Type:Individual
Prefix:DR
First Name:KARLYNA
Middle Name:L D
Last Name:ANDERSEN
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:NAVAL BRANCH HEALTH CLINIC
Mailing Address - Street 2:1801 FULLER RD. SUITE A-01 BLDG 367
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39309-0001
Mailing Address - Country:US
Mailing Address - Phone:601-679-2232
Mailing Address - Fax:
Practice Address - Street 1:NAVAL BRANCH HEALTH CLINIC
Practice Address - Street 2:1801 FULLER RD. SUITE A-01 BLDG 367
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39309-0001
Practice Address - Country:US
Practice Address - Phone:601-679-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7421207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine