Provider Demographics
NPI:1972593432
Name:LIDDLE SAXTON, KATHERINE J (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:LIDDLE SAXTON
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:DEPT. 453 PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:137 W PARKER RD STE C
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4622
Practice Address - Country:US
Practice Address - Phone:828-438-9004
Practice Address - Fax:828-430-8197
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16048207K00000X
NC2019-00028207K00000X
SCMD16048207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1972593432Medicaid
NCNN5753AOtherMEDICARE PTAN
NCNN5753AOtherMEDICARE PTAN
SC160480Medicaid
SC20040525OtherSELECT HEALTH
SCG27209Medicare UPIN
SC126809OtherMEDCOST