Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 17319 | WI |
Y | 208800000X | Urologist | 17319-020 | WI |
NPI | 1053497131 |
---|---|
Provider Name | David J Katz |
First Address | Eau Claire, WI 54701-6995 |
Second Address | Eau Claire, WI 54701-6995 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 03/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17319-020 | LICENSE (01) | WI |
19-00255 | MEDICA (01) | WI |
208D3KA | HMO OF WISCONSIN (01) | WI |
31066600 | (05) | WI |
5493 | SECURITY HEALTH PLAN (01) | WI |
B54027 | (02) | WI |
KOO217 | WAUSAU INSURANCE (01) | WI |