Individual
MRS. KATHRYN MARIE EKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 MERRITT DR STE 100, HENDERSON, KY 42420-2788
(270) 827-0064
(270) 826-3338
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6879
(270) 389-3707
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47919
KY
207R00000X
Internal Medicine Physician
7471451-1205
UT
208000000X
Pediatrics Physician
47919
KY
208000000X
Pediatrics Physician
7471451-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100345240
—
KY
Enumeration date
11/02/2008
Last updated
10/07/2019
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