Provider Demographics
NPI:1083001283
Name:SCHOTT, KATHRYN ROSA (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ROSA
Last Name:SCHOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 N JOHN B DENNIS HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-5918
Mailing Address - Country:US
Mailing Address - Phone:423-392-6690
Mailing Address - Fax:423-392-6695
Practice Address - Street 1:2202 N JOHN B DENNIS HWY STE 200
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-5918
Practice Address - Country:US
Practice Address - Phone:423-232-6120
Practice Address - Fax:423-232-6125
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-25
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC209856207L00000X
TN61498208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ059366Medicaid