NPI 1316975741 · live from the CMS NPI Registry
Kathleen C Antolak, M.D.
Family Medicine in Bend, OR. National Provider Identifier 1316975741, active.
NPI record
| NPI | 1316975741 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 1501 Ne Medical Center Dr, Bend, OR 97701 |
| Practice phone | 541-382-2811 |
| Enumerated | June 28, 2006 |
| Last updated | January 29, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | MD23421 (OR) |
| Specialist | 174400000X | MD23421 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.