Provider Demographics
NPI:1265582407
Name:HEARTY, KAREN M (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:HEARTY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1000 E PRIMROSE ST
Mailing Address - Street 2:SUITE 560
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5154
Mailing Address - Country:US
Mailing Address - Phone:417-882-1600
Mailing Address - Fax:417-631-0119
Practice Address - Street 1:1000 E PRIMROSE ST
Practice Address - Street 2:SUITE 560
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5154
Practice Address - Country:US
Practice Address - Phone:417-882-1600
Practice Address - Fax:417-882-1302
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2013-10-22
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Provider Licenses
StateLicense IDTaxonomies
MOR3L30208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO17682OtherBLUE CHOICE INSURANCE
MO202806105Medicaid