Provider Demographics
NPI:1518011337
Name:KAREN BERRY, M.D., P.C.
Entity type:Organization
Organization Name:KAREN BERRY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:901-405-6474
Mailing Address - Street 1:PO BOX 40997
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38174-0997
Mailing Address - Country:US
Mailing Address - Phone:901-405-6474
Mailing Address - Fax:901-747-2338
Practice Address - Street 1:1715 AARON BRENNER DR
Practice Address - Street 2:SUITE 326
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1442
Practice Address - Country:US
Practice Address - Phone:901-405-6474
Practice Address - Fax:901-747-2338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000170872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA98752Medicare UPIN
TN3733143Medicare ID - Type Unspecified