Provider Demographics
NPI:1023022167
Name:KATZ, JON MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:MICHAEL
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 GOOD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2433
Mailing Address - Country:US
Mailing Address - Phone:717-544-3514
Mailing Address - Fax:717-544-3515
Practice Address - Street 1:694 GOOD DR STE 200
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-544-3514
Practice Address - Fax:717-544-3515
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426592207V00000X, 207VM0101X, 207VM0101X
MDD41736207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0101010Medicaid
PA2137715OtherMAMSI-WMG
MD544507OtherCAREFIRST MD BCBS
PA595175OtherHIGHMARK BLUE SHIELD
PA4271568OtherAETNA
PA0417557000OtherAMERIHEALTH 65 PA
PA167766OtherUNISON-WMG
PA50050088OtherCAPITAL BLUE CROSS-WMG
PA1528497OtherGATEWAY-WMG
PA100453OtherGEISINGER
PA20044315OtherAMERIHEALTH MERCY-WMG
PA027812OtherJOHNS HOPKINS
PA101276446Medicaid
PA167766OtherUNISON-WMG
PA027812OtherJOHNS HOPKINS