Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 016005525 | IL |
N | 213ES0103X | Foot & Ankle Surgery | 1043-25 | WI |
N | 213ES0103X | Foot & Ankle Surgery | 10921738-0501 | UT |
N | 213ES0131X | Foot Surgery | 003749 | OH |
Y | 213ES0131X | Foot Surgery | 10921738-0501 | UT |
N | 213ES0131X | Foot Surgery | SC006790 | PA |
NPI | 1366734394 |
---|---|
Provider Name | Dr. Kathryn C Decker |
First Address | Riverton, UT 84065-7299 |
Second Address | Riverton, UT 84096-7405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2011 |
Last Update Date | 17/10/2019 |