MEDICARE: MS. KATHRYN K O AU 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	231H00000X	Audiologist	AT000772L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0291863	OTHER	PA	HIGHMARK BLUE SHIELD
2	01749301	OTHER	PA	CAPITAL BLUE CROSS

General Provider Information

NPI Number	:	1750345195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHRYN K O AU D

Provider Business Mailing Address
First Line	:	13161 FERGUSON VALLEY ROAD
Second Line	:	PO BOX 414
City	:	YEAGERTOWN
State	:	PA
Zip	:	17099
Country	:	US
Telephone Number	:	717-248-7248
Fax Number	:	717-248-7323

Provider Business Practice Location Address
First Line	:	13161 FERGUSON VALLEY ROAD
Second Line	:
City	:	YEAGERTOWN
State	:	PA
Zip	:	17099
Country	:	US
Telephone Number	:	717-248-7248
Fax Number	:	717-248-7323

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	07/08/2007

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