Doctor Name: | MR. YADOLAH KARNAMA |
NPI Number: | 1093701989 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 26392 |
Business Practice Address: | 1223 S Gear Avenue Suite 207 West Burlington, IA - 526551693 |
Business Phone Number: | 3197528424 |
Business Fax Number: | 3197527327 |
Mailing Address: | 1223 S Gear Avenue Suite 207, WEST BURLINGTON |
State: | IA |
Postal Code: | 526551693 |
Phone Number: | 3197528424 |
Fax Number: | 3197527327 |
NPI Enumeration Date: | 09/26/2005 |
NPI Last Update Date: | 06/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1100X |
License Number: | 26392 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Ophthalmic |
Taxonomy Definition: |