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General NPI Number Information
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NPI Number | 1780848820
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Entity Type | Individual
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Provider Name | KATHERINE MARIE EBSWORTH-MOJICA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 2004 CUMBERLAND AVE STE 301
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City | MIDDLESBORO
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State | KY
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Zip | 40965-1385
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Country | US
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Telephone | 606-248-3091
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Fax | 606-248-8526
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Provider Business Mailing Address
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Address Line | 2004 CUMBERLAND AVE STE 301
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City | MIDDLESBORO
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State | KY
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Zip | 40965-1385
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Country | US
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Telephone | 606-248-3091
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Fax | 606-248-8526
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 51829
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 51829
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License Number State | KY
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