Provider Demographics
NPI:1518997162
Name:PARKINSON, KATHERINE E (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:E
Last Name:PARKINSON
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 1:114 TIMBERLANE RD
Mailing Address - Street 2:
Mailing Address - City:SPOONER
Mailing Address - State:WI
Mailing Address - Zip Code:54801-9687
Mailing Address - Country:US
Mailing Address - Phone:715-635-3766
Mailing Address - Fax:715-635-3711
Practice Address - Street 1:114 TIMBERLANE RD
Practice Address - Street 2:
Practice Address - City:SPOONER
Practice Address - State:WI
Practice Address - Zip Code:54801-9687
Practice Address - Country:US
Practice Address - Phone:715-635-3766
Practice Address - Fax:715-635-3711
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36649020174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIF57159Medicare UPIN