Provider Demographics
NPI:1396963880
Name:KARR FOOT KARE, PA
Entity type:Organization
Organization Name:KARR FOOT KARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KARR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:863-646-5960
Mailing Address - Street 1:5421 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2523
Mailing Address - Country:US
Mailing Address - Phone:863-646-5960
Mailing Address - Fax:863-644-2847
Practice Address - Street 1:5421 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2523
Practice Address - Country:US
Practice Address - Phone:863-646-5960
Practice Address - Fax:863-644-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2590213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4482910001Medicare NSC