Provider Demographics
NPI:1568416436
Name:KATZ, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
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 1:4170 ROSSLYN DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1197
Mailing Address - Country:US
Mailing Address - Phone:513-527-0408
Mailing Address - Fax:513-872-4518
Practice Address - Street 1:4170 ROSSLYN DR
Practice Address - Street 2:SUITE B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1197
Practice Address - Country:US
Practice Address - Phone:513-527-0408
Practice Address - Fax:513-872-4518
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350387972085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64866403Medicaid
IN100341390Medicaid
OH0392552Medicaid
OH4132762Medicare PIN
OHE50682Medicare UPIN
OH0392552Medicaid