Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD016771 | LA |
N | 207ND0900X | Dermatopathologist | 16771 | LA |
NPI | 1679594212 |
---|---|
Provider Name | Dr. Kate Kathleen Mcdonald |
First Address | Slidell, LA 70461-5591 |
Second Address | Slidell, LA 70461-5591 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 07/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1351733 | (05) | LA |
52344 | MEDICARE (01) | LA |
B89528 | (02) | LA |