Provider Demographics
NPI:1245235340
Name:KARL, DEANNA FACUNDUS (MD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:FACUNDUS
Last Name:KARL
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:PO BOX 8488
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70011-8488
Mailing Address - Country:US
Mailing Address - Phone:504-834-2062
Mailing Address - Fax:504-831-7429
Practice Address - Street 1:1401 FOUCHER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3515
Practice Address - Country:US
Practice Address - Phone:504-897-8380
Practice Address - Fax:504-897-8011
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0198782085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03936353Medicaid
LA1660761Medicaid
AL009942912Medicaid
AL009942912Medicaid
MS03936353Medicaid
LA5W166CV55Medicare PIN