1417944109 NPI number — DR. ARTHUR H KATZ M.D.

Table of content: DR. ARTHUR H KATZ M.D. (NPI 1417944109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417944109 NPI number — DR. ARTHUR H KATZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KATZ
Provider First Name:
ARTHUR
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417944109
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1950 45TH STREET
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
MUNSTER
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46321-3927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-934-9396
Provider Business Mailing Address Fax Number:
219-924-7899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1950 45TH STREET
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
MUNSTER
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46321-3927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-934-9396
Provider Business Practice Location Address Fax Number:
219-924-7899
Provider Enumeration Date:
09/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  036-055188 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Y00000X , with the licence number: 01027712A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2275913 . This is a "AETNA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 363140314C . This is a "HUMANA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200859940A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: K34318 . This is a "MEDICARE ID - TYPE UNSPECIFIED" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 200859940B , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 520377 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 21609195 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 363140314001 . This is a "CHAMPUS/TRICARE (ME)" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 036055188 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 363140314002 . This is a "CHAMPUS/TRICARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 363140314C . This is a "HUMANA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 4028726 . This is a "AETNA" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000095404 . This is a "ANTHEM BCBS OF IN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 2275913 . This is a "AETNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 363140314 . This is a "CHAMPUS/TRICARE (MU)" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 4028726 . This is a "AETNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 520377 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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