Provider Demographics
NPI:1073958914
Name:PERCY, KATHERINE DENISE (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:DENISE
Last Name:PERCY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:DENISE
Other - Last Name:BECKHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 JARRETT WHITE ROAD
Mailing Address - Street 2:TRIPLER ARMY MEDICAL CENTER
Mailing Address - City:1 JARRETT WHITE ROAD
Mailing Address - State:HI
Mailing Address - Zip Code:96859-9685
Mailing Address - Country:US
Mailing Address - Phone:808-433-2778
Mailing Address - Fax:808-433-4982
Practice Address - Street 1:1 JARRETT WHITE ROAD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER
Practice Address - City:1 JARRETT WHITE ROAD
Practice Address - State:HI
Practice Address - Zip Code:96859-5095
Practice Address - Country:US
Practice Address - Phone:808-433-2778
Practice Address - Fax:808-433-4982
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1765207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine