Provider Demographics
NPI:1851379556
Name:MCNUTT, KATHY A (DO)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:A
Last Name:MCNUTT
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Gender:F
Credentials:DO
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Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE SUITE 001
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-432-5869
Mailing Address - Fax:412-432-5640
Practice Address - Street 1:464 ALLEGHENY BLVD
Practice Address - Street 2:PENNWOOD CENTER SUITE 2D
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-6210
Practice Address - Country:US
Practice Address - Phone:814-437-6793
Practice Address - Fax:814-437-6797
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2017-03-30
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Provider Licenses
StateLicense IDTaxonomies
PAOS012230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011261620002Medicaid
PA1011261620002Medicaid
I21111Medicare UPIN