Provider Demographics
NPI:1952627598
Name:KARL J HAPCIC M.D., LLC
Entity Type:Organization
Organization Name:KARL J HAPCIC M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAPCIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-564-5888
Mailing Address - Street 1:1315 S PUEBLO BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-2191
Mailing Address - Country:US
Mailing Address - Phone:719-564-5888
Mailing Address - Fax:719-564-1158
Practice Address - Street 1:1315 S PUEBLO BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-2191
Practice Address - Country:US
Practice Address - Phone:719-564-5888
Practice Address - Fax:719-564-1158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO365971223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty