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NPI Code Detail

MEDICARE: DR. KATHERINE JO BARTLETT

MEDICARE: DR. KATHERINE JO BARTLETT
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
1122300000XDentistDN15622FL

General Provider Information

NPI Number : 1043438187
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHERINE JO BARTLETT
Provider Business Mailing Address
First Line : 705 SIXTH ST
Second Line :
City : DESTIN
State : FL
Zip : 32541-1902
Country : US
Telephone Number : 850-305-3677
Fax Number :
Provider Business Practice Location Address
First Line : 208 HOSPITAL DR NE
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-5068
Country : US
Telephone Number : 850-243-8124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/14/2022

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Directions to “ DR. KATHERINE JO BARTLETT ” Practice Location

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