Provider Demographics
NPI:1871971101
Name:WINDHAM, KATHERINE CURTIS
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:CURTIS
Last Name:WINDHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:LEE
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 HOSPITAL DR STE 3
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1921
Mailing Address - Country:US
Mailing Address - Phone:662-327-0996
Mailing Address - Fax:
Practice Address - Street 1:300 HOSPITAL DR STE 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1921
Practice Address - Country:US
Practice Address - Phone:662-327-0995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPEDO-531-171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry