Provider Demographics
NPI:1194759662
Name:KARST, J MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:MICHAEL
Last Name:KARST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4485 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-3102
Mailing Address - Country:US
Mailing Address - Phone:334-272-4302
Mailing Address - Fax:334-272-0195
Practice Address - Street 1:4485 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3102
Practice Address - Country:US
Practice Address - Phone:334-272-4302
Practice Address - Fax:334-272-0195
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL13546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51081116OtherBLUE CROSS BLUE SHIELD
GA200006016OtherRAILROAD MEDICARE
AL529001630Medicaid
AL529001630Medicaid
AL51081116OtherBLUE CROSS BLUE SHIELD