Healthcare Provider Details

I. General information

NPI: 1356282826
Provider Name (Legal Business Name): KATHRYN OSTERLOH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

2703 ANDOVER HILL WAY APT 114
KNOXVILLE TN
37931-3714
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-1000
  • Fax:
Mailing address:
  • Phone: 901-634-0166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number120256980
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: