Basic Information
Provider Information
NPI: 1578973954
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THROWER
FirstName: MARY KATHERINE
MiddleName: LEONARD
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 503 CLARK ST NE
Address2:  
City: CULLMAN
State: AL
PostalCode: 350551921
CountryCode: US
TelephoneNumber: 2567390801
FaxNumber: 2567390027
Practice Location
Address1: 101 2ND AVE SE
Address2:  
City: CULLMAN
State: AL
PostalCode: 35055
CountryCode: US
TelephoneNumber: 2567394910
FaxNumber: 2567399455
Other Information
ProviderEnumerationDate: 05/06/2014
LastUpdateDate: 12/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/22/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X35023ALY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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