Provider Demographics
NPI:1790989192
Name:KATHERINE JAWOR DO PLLC
Entity Type:Organization
Organization Name:KATHERINE JAWOR DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAWOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-737-1213
Mailing Address - Street 1:427 SEMINOLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3747
Mailing Address - Country:US
Mailing Address - Phone:231-737-1213
Mailing Address - Fax:231-737-1218
Practice Address - Street 1:427 SEMINOLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-3747
Practice Address - Country:US
Practice Address - Phone:231-737-1213
Practice Address - Fax:231-737-1218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010122702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI017514OtherPRIORITY HEALTH
MI2657010734OtherBCBS
MI2657010734OtherBCBS