Provider Demographics
NPI:1679570444
Name:KARASEK, JOEL PHILLIP (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:PHILLIP
Last Name:KARASEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3649
Mailing Address - Country:US
Mailing Address - Phone:816-232-6601
Mailing Address - Fax:816-232-6606
Practice Address - Street 1:3955 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3649
Practice Address - Country:US
Practice Address - Phone:816-232-6601
Practice Address - Fax:816-232-6606
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206948622Medicaid