1538696406 NPI number — DR. KATHARINE LINDSEY NEFF DO

Table of content: DR. KATHARINE LINDSEY NEFF DO (NPI 1538696406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538696406 NPI number — DR. KATHARINE LINDSEY NEFF DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEFF
Provider First Name:
KATHARINE
Provider Middle Name:
LINDSEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538696406
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DAVIS MONTHAN AIR FORCE BASE MEDICAL CLINIC
Provider Second Line Business Mailing Address:
4175 S ALAMO AVE
Provider Business Mailing Address City Name:
DAVIS-MONTHAN AFB
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-228-2778
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DAVIS MONTHAN MEDICAL CLINIC
Provider Second Line Business Practice Location Address:
4175 S ALAMO AVE
Provider Business Practice Location Address City Name:
DAVIS-MONTHAN AFB
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85707-7059
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-228-2778
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  02005577A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)