MEDICARE: DR. KATELYN BOWMAN FEINBERG D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	6061	AL

General Provider Information

NPI Number	:	1578984514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATELYN BOWMAN FEINBERG D.M.D.

Provider Business Mailing Address
First Line	:	30 PINE CREST RD
Second Line	:
City	:	MOUNTAIN BRK
State	:	AL
Zip	:	35223-1263
Country	:	US
Telephone Number	:	804-564-5612
Fax Number	:

Provider Business Practice Location Address
First Line	:	5391 MAGNOLIA TRCE
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4622
Country	:	US
Telephone Number	:	205-733-2022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2013
Last Update Date	:	11/19/2019

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