Basic Information
Provider Information
NPI: 1144683103
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RHYMES
FirstName: KATHRYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 1512 W KIRBY PL
Address2:  
City: SHREVEPORT
State: LA
PostalCode: 711033822
CountryCode: US
TelephoneNumber: 3186260287
FaxNumber:  
Practice Location
Address1: 4864 JACKSON ST
Address2:  
City: MONROE
State: LA
PostalCode: 712026400
CountryCode: US
TelephoneNumber: 3183307000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/29/2016
LastUpdateDate: 05/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X327691LAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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