Healthcare Provider Details

I. General information

NPI: 1083062913
Provider Name (Legal Business Name): CATHERINE ELIZABETH KERR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

2717 ROSEWOOD DR
AUGUSTA GA
30909-2319
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-9442
  • Fax:
Mailing address:
  • Phone: 706-716-9332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number83104
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number008268
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: