Provider Demographics
NPI:1992708622
Name:LOCKE, KAREN CROSS (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:CROSS
Last Name:LOCKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2270
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2270
Mailing Address - Country:US
Mailing Address - Phone:970-963-3350
Mailing Address - Fax:970-963-1082
Practice Address - Street 1:978 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1820
Practice Address - Country:US
Practice Address - Phone:970-963-3350
Practice Address - Fax:970-963-1082
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38022207Q00000X
CODR.0038022207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF92333Medicare UPIN
549118Medicare ID - Type Unspecified