Doctor Name: | DR. KATHLEEN MARIE PERSKY |
NPI Number: | 1952309288 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 00G566600 |
Business Practice Address: | 246 Hospital Dr Ukiah, CA - 954824533 |
Business Phone Number: | 7074638011 |
Business Fax Number: | 7074638044 |
Mailing Address: | Po Box 2739, UKIAH |
State: | CA |
Postal Code: | 954822739 |
Phone Number: | 7074638000 |
Fax Number: | 7074621111 |
NPI Enumeration Date: | 07/11/2005 |
NPI Last Update Date: | 06/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 00G566600 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |