Provider Demographics
NPI:1659323681
Name:TWOMLEY, KATIE M (MD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:M
Last Name:TWOMLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:M
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-6768
Mailing Address - Country:US
Mailing Address - Phone:336-238-4077
Mailing Address - Fax:336-236-2544
Practice Address - Street 1:10 MEDICAL PARK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6768
Practice Address - Country:US
Practice Address - Phone:336-238-4077
Practice Address - Fax:336-236-2544
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200600432208M00000X
NC2006-00432207RC0000X
NC117192207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903706Medicaid
NC2051996AMedicare PIN