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NPI Code Detail

MEDICARE: KATHERINE BIVONA MD

MEDICARE:   KATHERINE  BIVONA  MD
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
1207Q00000XFamily Medicine Physician27661AL

General Provider Information

NPI Number : 1255482832
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE BIVONA MD
Provider Business Mailing Address
First Line : PO BOX 1474
Second Line :
City : JASPER
State : AL
Zip : 35502
Country : US
Telephone Number : 205-221-9351
Fax Number : 205-221-3700
Provider Business Practice Location Address
First Line : 2201 N AIRPORT RD
Second Line :
City : JASPER
State : AL
Zip : 35504-7058
Country : US
Telephone Number : 205-221-9351
Fax Number : 205-221-4353
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 11/30/2018

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Directions to “ KATHERINE BIVONA MD” Practice Location

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