Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 20694 | IA |
NPI | 1083608772 |
---|---|
Provider Name | Louis M Katz |
First Address | Davenport, IA 52801-1014 |
Second Address | Davenport, IA 52804-1853 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 19/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
033967 | HEALTH ALLIANCE (01) | |
1214686 | CONTROLLED SUBSTANCE# (01) | IA |
421060724 | BILLING TAX ID# FOR CHC (01) | IA |
421060724007 | (05) | IL |
42106072451 | JOHN DEERE HEALTH (01) | IA |
53200 | IOWA BC/BS (01) | IA |
8122859 | ILLINOIS BC/BS (01) | IL |
A03898 | (02) | IA |
AK8307248 | FEDERAL DEA# (01) | |
IA0151 | JOHN DEERE EDI# (01) | IA |