Provider Demographics
NPI:1750340352
Name:LARRIMORE, CATHY TONER (MD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:TONER
Last Name:LARRIMORE
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 1:4181 HOSPITAL DR NE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2541
Mailing Address - Country:US
Mailing Address - Phone:770-385-8954
Mailing Address - Fax:770-385-8590
Practice Address - Street 1:4181 HOSPITAL DR NE
Practice Address - Street 2:SUITE 104
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2541
Practice Address - Country:US
Practice Address - Phone:770-385-8954
Practice Address - Fax:770-385-8590
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038836207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA471590234AMedicaid
GA16BBCFZMedicare PIN
GAI00696Medicare UPIN