Provider Demographics
NPI:1649365032
Name:DEARING, KATHRYN LORRAINE (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LORRAINE
Last Name:DEARING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 RUNNING DEER TRAIL
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005
Mailing Address - Country:US
Mailing Address - Phone:937-760-5903
Mailing Address - Fax:937-667-8067
Practice Address - Street 1:1483 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2803
Practice Address - Country:US
Practice Address - Phone:937-667-7711
Practice Address - Fax:937-667-8067
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054163A208000000X
OH350904702080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics