Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 19955 | AL |
N | 208600000X | Surgeon | 19955 | AL |
N | 2086S0102X | Surgical Critical Care | 00019955 | AL |
N | 2086S0102X | Surgical Critical Care | 19955 | AL |
N | 2086S0127X | Trauma Surgeon | 00019955 | AL |
Y | 2086S0127X | Trauma Surgeon | 19955 | AL |
NPI | 1053386623 |
---|---|
Provider Name | Dr. Deepak Katyal |
First Address | Huntsville, AL 35804-2705 |
Second Address | Huntsville, AL 35801-5134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 22/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000031307 | (05) | AL |
051031307 | BCBS (01) | AL |
G35167 | (02) | AL |