Provider Demographics
NPI:1194791673
Name:KARLS, JEFFREY P (DO)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:P
Last Name:KARLS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:814-297-7070
Mailing Address - Fax:814-297-7072
Practice Address - Street 1:30 PINNACLE DR STE 101A
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-3882
Practice Address - Country:US
Practice Address - Phone:814-297-7070
Practice Address - Fax:814-297-7072
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006981E207QG0300X, 207Q00000X
MO2009007996207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP001985OtherGATEWAY
MOP00716884OtherRAILROAD MEDICARE
PA0012805170009Medicaid
PAE36070Medicare UPIN
PAP001985OtherGATEWAY