Provider Demographics
NPI:1548467897
Name:DAUPHINAIS, KARL (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:DAUPHINAIS
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 1:1245 FARMINGTON AVE
Mailing Address - Street 2:# 226
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2667
Mailing Address - Country:US
Mailing Address - Phone:860-470-6630
Mailing Address - Fax:862-298-0763
Practice Address - Street 1:21 SOUTH ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032
Practice Address - Country:US
Practice Address - Phone:860-284-4945
Practice Address - Fax:860-284-4946
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine