Basic Information
| Provider Information | |||||||||
| NPI: | 1568990869 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARTLETT | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | BROOKE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 783311 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191783311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844500 | ||||||||
| FaxNumber: | 4848840699 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 SCHUYLKILL MEDICAL PLZ | ||||||||
| Address2: | |||||||||
| City: | POTTSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 179013660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706219200 | ||||||||
| FaxNumber: | 5706219201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | OT017594 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | OS020150 | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.