Provider Demographics
NPI:1164709143
Name:JOHN LITZ JR. M.D. PA
Entity Type:Organization
Organization Name:JOHN LITZ JR. M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LITZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:856-429-2441
Mailing Address - Street 1:411 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2512
Mailing Address - Country:US
Mailing Address - Phone:856-429-2441
Mailing Address - Fax:856-429-0331
Practice Address - Street 1:411 KINGS HWY S
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2512
Practice Address - Country:US
Practice Address - Phone:856-429-2441
Practice Address - Fax:856-429-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49176207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty