Individual
KATHY JACKSON TEASDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
755 HIGHLAND OAKS DR, STE 204, WINSTON SALEM, NC 27103-7106
(336) 768-1037
(336) 768-9141
Mailing address
755 HIGHLAND OAKS DR, STE 204, WINSTON SALEM, NC 27103-7106
(336) 768-1037
(336) 768-9141
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
9400157
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8982338
—
NC
Enumeration date
06/21/2006
Last updated
06/20/2013
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