Provider Demographics
NPI:1124068986
Name:CALCOTT, KAREN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:CALCOTT
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 1:110 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BUCKSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04416-4612
Mailing Address - Country:US
Mailing Address - Phone:207-469-7371
Mailing Address - Fax:207-469-7306
Practice Address - Street 1:110 BROADWAY
Practice Address - Street 2:
Practice Address - City:BUCKSPORT
Practice Address - State:ME
Practice Address - Zip Code:04416-4612
Practice Address - Country:US
Practice Address - Phone:207-469-7371
Practice Address - Fax:207-469-7306
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD15665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME7380254OtherAETNA
ME316450099Medicaid
MEMM901901OtherMED B - PERS FOR PPC
MEAA67288OtherHARVARD PILGRIM
ME061541OtherANTHEM
ME061541OtherANTHEM
H46843Medicare UPIN
MEMM901901OtherMED B - PERS FOR PPC
MECAMM9019Medicare PIN