Provider Demographics
NPI:1609868454
Name:LOVLIE, KATHLEEN COLE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:COLE
Last Name:LOVLIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:COLE
Other - Last Name:VANSYOC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:232 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-3432
Mailing Address - Country:US
Mailing Address - Phone:251-968-2323
Mailing Address - Fax:251-968-2134
Practice Address - Street 1:232 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3432
Practice Address - Country:US
Practice Address - Phone:251-968-2323
Practice Address - Fax:251-968-2134
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22320208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL39807OtherBCBS
G86480Medicare UPIN