Provider Demographics
NPI:1932196045
Name:VALENTINE, KARL JOHN (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:JOHN
Last Name:VALENTINE
Suffix:
Gender:M
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 76
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-0076
Mailing Address - Country:US
Mailing Address - Phone:614-220-7723
Mailing Address - Fax:
Practice Address - Street 1:4661 SAWMILL ROAD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OHIO
Practice Address - Zip Code:43220
Practice Address - Country:UM
Practice Address - Phone:614-583-1133
Practice Address - Fax:614-583-1138
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050629V207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A16062Medicare UPIN
OHVA086641Medicare ID - Type Unspecified