Provider Demographics
NPI:1427194349
Name:EGERTON, KATHRYN POPE (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:POPE
Last Name:EGERTON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:LEE
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:206 MEADOWBROOK TER
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-6528
Mailing Address - Country:US
Mailing Address - Phone:336-686-9555
Mailing Address - Fax:
Practice Address - Street 1:2001 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5633
Practice Address - Country:US
Practice Address - Phone:336-375-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006020598213E00000X
NC528213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2437009Medicare PIN