Provider Demographics
NPI:1174506166
Name:FELKER, KATHLEEN JO (MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:JO
Last Name:FELKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN550812085R0202X
AL231242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009942882Medicaid
AL009982340Medicaid
AL213436Medicaid
AL239844Medicaid
AL247288Medicaid
AL890-43913OtherBCBS
AL009911026Medicaid
AL009982330Medicaid
AL245799Medicaid
AL51067173OtherBCBS
AL51595719OtherBCBS
AL245598Medicaid
AL51507013OtherBCBS OF AL
AL51595726OtherBCBS
AL51595727OtherBCBS
AL051551437Medicaid
AL127005Medicaid
AL135840Medicaid
AL245578Medicaid
AL246027Medicaid
AL890-51500OtherBCBS
AL009982320Medicaid
AL245822Medicaid
AL51595720OtherBCBS
AL51595724OtherBCBS
AL51595725OtherBCBS