Provider Demographics
NPI:1376237099
Name:HARITATOS, KAITLYN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ELIZABETH
Last Name:HARITATOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:ELIZABETH
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2101
Mailing Address - Country:US
Mailing Address - Phone:423-778-5437
Mailing Address - Fax:
Practice Address - Street 1:900 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2101
Practice Address - Country:US
Practice Address - Phone:423-778-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program