Provider Demographics
NPI:1881008340
Name:LEE-KALSCH, KATHRYN M (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:LEE-KALSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P. O. BOX 717
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47620-0717
Mailing Address - Country:US
Mailing Address - Phone:812-838-4891
Mailing Address - Fax:812-838-6595
Practice Address - Street 1:1900 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IN
Practice Address - Zip Code:47620-9407
Practice Address - Country:US
Practice Address - Phone:812-838-4891
Practice Address - Fax:812-838-6595
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01078625A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine