Provider Demographics
NPI:1871791301
Name:DAVIS, KATHRYN LORANN (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LORANN
Last Name:DAVIS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33369
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28233-3369
Mailing Address - Country:US
Mailing Address - Phone:704-916-2108
Mailing Address - Fax:719-473-3553
Practice Address - Street 1:2001 VAIL AVE STE 320
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1222
Practice Address - Country:US
Practice Address - Phone:704-333-0741
Practice Address - Fax:704-365-2073
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY452352086S0129X
NDLT167082086S0129X
NC2019-013302086S0129X
MN680172086S0129X
CO536012086S0129X
IL0361690482086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty