Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 49181 | GA |
NPI | 1124120829 |
---|---|
Provider Name | Dr. Randy S Katz |
First Address | Atlanta, GA 30329-2208 |
Second Address | Atlanta, GA 30329-2208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 30/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H70398 | (02) | GA |