Individual
KARRIE L. KISKADDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MEADOW LN, SUITE 4, DU BOIS, PA 15801-2460
(814) 371-3730
(814) 371-9335
Mailing address
PO BOX 447, DU BOIS, PA 15801-0447
(814) 371-3730
(814) 371-9335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD434624
PA
207Q00000X
Family Medicine Physician
MT187193
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102087381
—
PA
Enumeration date
05/18/2007
Last updated
10/06/2015
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