Provider Demographics
NPI:1871554998
Name:DAHL, CATHY L (DO)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:L
Last Name:DAHL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1112 W 6TH ST
Mailing Address - Street 2:STE 212
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2215
Mailing Address - Country:US
Mailing Address - Phone:785-727-7900
Mailing Address - Fax:785-727-7901
Practice Address - Street 1:1112 W 6TH ST
Practice Address - Street 2:STE 212
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2215
Practice Address - Country:US
Practice Address - Phone:785-727-7900
Practice Address - Fax:785-727-7901
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS05-29352207VF0040X
FLOS18826207VF0040X, 207V00000X
KS0529352207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSI43568Medicare UPIN