Provider Demographics
NPI:1689139909
Name:MAHON, KATHERINE M (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:MAHON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 ELM ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4626
Mailing Address - Country:US
Mailing Address - Phone:401-443-5122
Mailing Address - Fax:401-537-7241
Practice Address - Street 1:195 COLLYER ST STE 201
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-1869
Practice Address - Country:US
Practice Address - Phone:401-272-7799
Practice Address - Fax:401-453-9078
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD20668208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology