Provider Demographics
NPI:1336582907
Name:KATICH, ALEX D (DO)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:D
Last Name:KATICH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 NETWORK DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-8512
Mailing Address - Country:US
Mailing Address - Phone:412-841-8050
Mailing Address - Fax:
Practice Address - Street 1:125 N FRANKLIN DR STE 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5892
Practice Address - Country:US
Practice Address - Phone:724-229-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019271208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology