Healthcare Provider Details

I. General information

NPI: 1518317106
Provider Name (Legal Business Name): KATHERINE R DEAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAY DEAN

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 4TH AVE S
BIRMINGHAM AL
35233-1408
US

IV. Provider business mailing address

1317 4TH AVE S
BIRMINGHAM AL
35233-1408
US

V. Phone/Fax

Practice location:
  • Phone: 205-458-5000
  • Fax: 844-692-0014
Mailing address:
  • Phone: 205-458-5000
  • Fax: 844-692-0014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberLL39789
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number44538
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: