Provider Demographics
NPI:1023242476
Name:KARBACH, ROBERT JOHN II (IDMT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:KARBACH
Suffix:II
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9551 LUKE ST
Mailing Address - Street 2:
Mailing Address - City:MOODY A F B
Mailing Address - State:GA
Mailing Address - Zip Code:31699-1543
Mailing Address - Country:US
Mailing Address - Phone:229-257-8214
Mailing Address - Fax:229-257-2121
Practice Address - Street 1:9551 LUKE ST
Practice Address - Street 2:
Practice Address - City:MOODY A F B
Practice Address - State:GA
Practice Address - Zip Code:31699-1543
Practice Address - Country:US
Practice Address - Phone:229-257-8214
Practice Address - Fax:229-257-2121
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians