Individual ProviderKarl AstaphanFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address520 Jesse Jewell Pkwy SE, Gainesville, GA 30501-3779(770) 287-0290(706) 788-3234PECOS EnrollmentBased on the most recent information from CMS, provider Karl Astaphan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1891897492Provider TypeIndividualFull NameAstaphan, KarlCredentialMDGenderMaleSole ProprietorNoEnumeration Date9/2/2006Last Updated5/4/2022Contact InformationPractice LocationPractice Address520 Jesse Jewell Pkwy SE, Gainesville, GA 30501-3779Phone(770) 287-0290Fax(770) 287-7597Mailing LocationMailing AddressPO Box 459, Colbert, GA 30628-0459Phone(706) 788-3234Fax(706) 788-2936Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense037941GeorgiaProvider IdentifiersIDDescriptionIssuerID000781866EDescriptionMedicaidIssuerUnlistedGeorgia