Provider Demographics
NPI:1376509091
Name:CATON, KIRT A (MD)
Entity Type:Individual
Prefix:
First Name:KIRT
Middle Name:A
Last Name:CATON
Suffix:
Gender:M
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:PO BOX 118008
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29423-8008
Mailing Address - Country:US
Mailing Address - Phone:843-554-8312
Mailing Address - Fax:843-554-5141
Practice Address - Street 1:1254 YEAMANS HALL RD
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410-2787
Practice Address - Country:US
Practice Address - Phone:843-554-8312
Practice Address - Fax:843-554-5141
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00207315OtherMEDICARE RAIL ROAD
SC222930Medicaid
SCAA42675277Medicare PIN
SCP00207315OtherMEDICARE RAIL ROAD
SCAA42677555Medicare PIN
SCH409327126Medicare PIN
SCAA42677498Medicare PIN
SCAA42677819Medicare PIN
SCAA42678798Medicare PIN
SCH409326868Medicare PIN
SCH409326882Medicare PIN
SC222930Medicaid
SCH409327499Medicare PIN
SCH409327522Medicare PIN
SCAA42675282Medicare PIN
SCAA42675281Medicare PIN