Provider Demographics
NPI:1982680567
Name:KATULA, DOUGLAS A (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:KATULA
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 1:7277 SMITHS MILL RD STE 250
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8196
Mailing Address - Country:US
Mailing Address - Phone:614-221-3725
Mailing Address - Fax:614-221-5613
Practice Address - Street 1:7277 SMITHS MILL RD STE 250
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8196
Practice Address - Country:US
Practice Address - Phone:614-221-3725
Practice Address - Fax:614-221-5613
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.060292207RH0002X, 207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0901537Medicaid
OH0901537Medicaid
OH0713634Medicare PIN
OH4070993Medicare PIN