Provider Demographics
NPI:1992198410
Name:KATHERINE M WHIPPLE, MD, PC
Entity Type:Organization
Organization Name:KATHERINE M WHIPPLE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-507-8365
Mailing Address - Street 1:25 CINNAMON CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-8768
Mailing Address - Country:US
Mailing Address - Phone:585-507-8365
Mailing Address - Fax:
Practice Address - Street 1:25 CINNAMON CIR
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-8768
Practice Address - Country:US
Practice Address - Phone:585-507-8365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271321261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery