Provider Demographics
NPI:1871593368
Name:PEARCE, KATHERINE FARRIES (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:FARRIES
Last Name:PEARCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:K
Other - Last Name:FARRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0011
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:5131 ODONOVAN DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4791
Practice Address - Country:US
Practice Address - Phone:225-374-0220
Practice Address - Fax:225-374-0221
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1540188Medicaid
LA080124857OtherRAILROAD MEDICARE
LA5A658D279Medicare PIN
LA080124857OtherRAILROAD MEDICARE