Provider Demographics
NPI:1023076163
Name:HARGUS, KAREN ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANNE
Last Name:HARGUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:ANNE
Other - Last Name:LANIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2708 RIFE MEDICAL LN
Mailing Address - Street 2:SUITE T40
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:479-338-4000
Mailing Address - Fax:479-338-4050
Practice Address - Street 1:2708 RIFE MEDICAL LN
Practice Address - Street 2:SUITE T40
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-4000
Practice Address - Fax:479-338-4050
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4172207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR54499Medicare ID - Type Unspecified
AR119861001Medicaid
ARE82153Medicare UPIN