Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 9855 | AZ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 9855 | AZ |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 9855 | AZ |
NPI | 1194726711 |
---|---|
Provider Name | Jay Katz |
First Address | Tucson, AZ 85751-1630 |
Second Address | Tucson, AZ 85712-2805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2005 |
Last Update Date | 23/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201294 | (05) | AZ |
D37117 | (02) | AZ |