Basic Information
| Provider Information | |||||||||
| NPI: | 1750336376 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRYSON | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | FRANCES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174218 | ||||||||
| Practice Location | |||||||||
| Address1: | 46 WALNUT BOTTOM RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | SHIPPENSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172578219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175324148 | ||||||||
| FaxNumber: | 7175323561 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 09/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD424057 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 001619031 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 1007307260034 | 01 | PA | MEDICAID GROUP # | OTHER | 101199454 | 05 | PA | MEDICAID | 11303694 | 01 | CAQH | OTHER | 8375692 | 01 | PA | AETNA HMO | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | 7664638 | 01 | PA | AETNA NON-HMO | OTHER |