Provider Demographics
NPI:1942208160
Name:KARREN, KENT A (MD)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:A
Last Name:KARREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 OAK ST
Mailing Address - Street 2:SUITE #3
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7701
Mailing Address - Country:US
Mailing Address - Phone:541-683-2020
Mailing Address - Fax:541-683-1509
Practice Address - Street 1:1550 OAK ST
Practice Address - Street 2:SUITE #3
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7701
Practice Address - Country:US
Practice Address - Phone:541-683-2020
Practice Address - Fax:541-683-1509
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD 22688207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180040730OtherRAILROAD MEDICARE
180043374OtherRAILROAD MEDICARE
OR288291Medicaid
OR288291Medicaid
ORR110616Medicare PIN
F17447Medicare UPIN