Provider Demographics
NPI:1437625084
Name:CUNNINGHAM, KATHRYN NORTHCUTT (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:NORTHCUTT
Last Name:CUNNINGHAM
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 1:6434 COUNTY ROAD 95
Mailing Address - Street 2:
Mailing Address - City:ELBERTA
Mailing Address - State:AL
Mailing Address - Zip Code:36530-5728
Mailing Address - Country:US
Mailing Address - Phone:251-987-1639
Mailing Address - Fax:
Practice Address - Street 1:6434 COUNTY ROAD 95
Practice Address - Street 2:
Practice Address - City:ELBERTA
Practice Address - State:AL
Practice Address - Zip Code:36530-5728
Practice Address - Country:US
Practice Address - Phone:251-987-1639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine