Provider Demographics
NPI:1225081391
Name:PRICE, KATHERINE LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LOUISE
Last Name:PRICE
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 1:13139 SORRENTO RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8777
Mailing Address - Country:US
Mailing Address - Phone:850-416-0020
Mailing Address - Fax:850-492-6340
Practice Address - Street 1:13139 SORRENTO RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8777
Practice Address - Country:US
Practice Address - Phone:850-416-0020
Practice Address - Fax:850-492-6340
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74459207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253218200Medicaid
FL253218200Medicaid
FL42774Medicare ID - Type Unspecified