Basic Information
Provider Information
NPI: 1356591580
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KOTINSLEY
FirstName: KATHERINE
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FOX
OtherFirstName: KATHERINE
OtherMiddleName: ANN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 2500 METROHEALTH DR
Address2: DEPARTMENT OF RADIATION ONCOLOGY
City: CLEVELAND
State: OH
PostalCode: 441091900
CountryCode: US
TelephoneNumber: 2167787800
FaxNumber:  
Practice Location
Address1: 2500 METROHEALTH DR
Address2: DEPARTMENT OF RADIATION ONCOLOGY
City: CLEVELAND
State: OH
PostalCode: 441091900
CountryCode: US
TelephoneNumber: 2167787800
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/24/2008
LastUpdateDate: 12/15/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001X35.125171OHY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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