Provider Demographics
NPI:1598787434
Name:BARE, KATHLEEN U (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:U
Last Name:BARE
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 1:3803 HAUCK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1609
Mailing Address - Country:US
Mailing Address - Phone:513-733-2000
Mailing Address - Fax:513-733-2044
Practice Address - Street 1:3803 HAUCK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1609
Practice Address - Country:US
Practice Address - Phone:513-733-2000
Practice Address - Fax:513-733-2044
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-043891207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC02715Medicare UPIN
OHBA0546911Medicare ID - Type Unspecified