Provider Demographics
NPI:1760607394
Name:LAFAVOR, KATHLEEN MICHELE DORCEY (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MICHELE DORCEY
Last Name:LAFAVOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1000 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51105-1431
Mailing Address - Country:US
Mailing Address - Phone:712-252-0501
Mailing Address - Fax:712-252-2024
Practice Address - Street 1:1000 JACKSON ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51105-1431
Practice Address - Country:US
Practice Address - Phone:712-252-0501
Practice Address - Fax:712-252-2024
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5481207VX0000X, 207VG0400X
IA4075207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics