Provider Demographics
NPI:1992061303
Name:SMALL, KAREN W (MD)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:W
Last Name:SMALL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1690 A SPRING PORT DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:404-332-4855
Mailing Address - Fax:540-433-2010
Practice Address - Street 1:1690 A SPRING PORT DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:404-332-4855
Practice Address - Fax:540-433-2010
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2023-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA266401207W00000X
VA0101264198207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101264198OtherVIRGINIA STATE LICENSE