Provider Demographics
NPI:1316988793
Name:TORMEY, KAREN A (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:TORMEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S 300 E
Mailing Address - Street 2:STE 107
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3900
Mailing Address - Country:US
Mailing Address - Phone:435-674-7262
Mailing Address - Fax:435-674-5078
Practice Address - Street 1:515 S 300 E
Practice Address - Street 2:STE 107
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3900
Practice Address - Country:US
Practice Address - Phone:435-674-7262
Practice Address - Fax:435-674-5078
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT214243-1205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT077566OtherIHC ID NUMBER
UT17-90126OtherUHC ID #
UT020049756OtherRAILROAD MEDICARE ID #
UT5773304OtherAETNA ID NUMBER
UT077566OtherIHC ID NUMBER
UTG31038Medicare UPIN