Provider Demographics
NPI:1265792410
Name:HOMPESCH, CATHERINE KIM (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KIM
Last Name:HOMPESCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BOHYUN
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1001 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4948
Mailing Address - Country:US
Mailing Address - Phone:907-459-3500
Mailing Address - Fax:907-459-3532
Practice Address - Street 1:1001 NOBLE ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4948
Practice Address - Country:US
Practice Address - Phone:907-459-3500
Practice Address - Fax:907-459-3526
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK108269207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1649391Medicaid
AKK168031Medicare PIN