Provider Demographics
NPI:1821064619
Name:DOCTOR KATZ, INC (A PROFESSIONAL MEDICAL CORPORATION)
Entity Type:Organization
Organization Name:DOCTOR KATZ, INC (A PROFESSIONAL MEDICAL CORPORATION)
Other - Org Name:WESTSIDE ORTHOPAEDIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-347-0243
Mailing Address - Street 1:1301 BARATARIA BLVD
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3703
Mailing Address - Country:US
Mailing Address - Phone:504-347-0243
Mailing Address - Fax:504-349-2910
Practice Address - Street 1:1301 BARATARIA BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3703
Practice Address - Country:US
Practice Address - Phone:504-347-0243
Practice Address - Fax:504-349-2910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LACH4195OtherRAILROAD MEDICARE
LA5B906Medicare ID - Type Unspecified