Provider Demographics
NPI:1235129925
Name:O'DONNELL, KATHRYN ROBB (DO)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ROBB
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8525 CHASE GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-3307
Mailing Address - Country:US
Mailing Address - Phone:910-584-1093
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 808
Practice Address - Street 2:GUNSTON ROAD
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-0001
Practice Address - Country:US
Practice Address - Phone:910-584-1093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000007962083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine