Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 12013206A | IN |
NPI | 1114524477 |
---|---|
Provider Name | Katherine E. Ferry |
First Address | Columbus, IN 47201-4022 |
Second Address | Columbus, IN 47201-4022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2020 |
Last Update Date | 08/10/2020 |