Provider Demographics
NPI:1396909156
Name:BATH, KARAN KAMAL (MD)
Entity type:Individual
Prefix:
First Name:KARAN
Middle Name:KAMAL
Last Name:BATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 SOUTHCREST CIR STE 210
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-6721
Mailing Address - Country:US
Mailing Address - Phone:662-526-1944
Mailing Address - Fax:662-536-1947
Practice Address - Street 1:401 SOUTHCREST CIR STE 210
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-6721
Practice Address - Country:US
Practice Address - Phone:662-526-1944
Practice Address - Fax:662-536-1947
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME109975208600000X
CAA123894208600000X
MS22711208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery