Provider Demographics
NPI:1962686840
Name:KATHERYNE W GLANTZ LTD
Entity Type:Organization
Organization Name:KATHERYNE W GLANTZ LTD
Other - Org Name:HIGH DESERT FOOT AND ANKLE CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERYNE
Authorized Official - Middle Name:W
Authorized Official - Last Name:GLANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:775-331-3668
Mailing Address - Street 1:2345 E PRATER WAY
Mailing Address - Street 2:#315
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9600
Mailing Address - Country:US
Mailing Address - Phone:775-331-3668
Mailing Address - Fax:
Practice Address - Street 1:2345 E PRATER WAY
Practice Address - Street 2:#315
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-9600
Practice Address - Country:US
Practice Address - Phone:775-331-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9103A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU26053Medicare UPIN
NVVDPM9103AMedicare PIN
NV1154880001Medicare NSC