Provider Demographics
NPI:1184879637
Name:KATZ, JONAS BARRY (DPM)
Entity type:Individual
Prefix:DR
First Name:JONAS
Middle Name:BARRY
Last Name:KATZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 ISALNDVIEW COURT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-2527
Mailing Address - Country:US
Mailing Address - Phone:804-543-0531
Mailing Address - Fax:
Practice Address - Street 1:2401 ISLANDVIEW CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-2527
Practice Address - Country:US
Practice Address - Phone:804-543-0531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000289B213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT21370Medicare UPIN