Provider Demographics
NPI:1871542597
Name:ENGLISH, KATHERINE S (DO)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 LAKE LANSING RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3753
Mailing Address - Country:US
Mailing Address - Phone:517-487-0128
Mailing Address - Fax:517-487-2639
Practice Address - Street 1:1515 LAKE LANSING RD
Practice Address - Street 2:SUITE A
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3753
Practice Address - Country:US
Practice Address - Phone:517-487-0128
Practice Address - Fax:517-487-2639
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKE015076207N00000X, 207NS0135X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4602249Medicaid
MI73 00079OtherPHP
MIKE015076OtherSTATE LICENSE
MIKE015076OtherSTATE LICENSE
MIC36066015Medicare ID - Type Unspecified
MI4602249Medicaid