Provider Demographics
NPI:1467408641
Name:KATZ, BARRY IRVING (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:IRVING
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 MERCY WAY
Mailing Address - Street 2:SUITE 520
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4524
Mailing Address - Country:US
Mailing Address - Phone:417-556-6876
Mailing Address - Fax:417-556-6874
Practice Address - Street 1:100 MERCY WAY
Practice Address - Street 2:SUITE 520
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-556-6876
Practice Address - Fax:417-556-6874
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-6266207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE-6266OtherMEDICAL LICENSE
NC8912117Medicaid
NC8912117Medicaid