Provider Demographics
NPI:1952618605
Name:KATZ, BRIAN D (PAC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:KATZ
Suffix:
Gender:M
Credentials:PAC
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Mailing Address - Street 1:1121 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-5425
Mailing Address - Country:US
Mailing Address - Phone:770-509-1025
Mailing Address - Fax:770-509-1884
Practice Address - Street 1:3525 PIEDMONT RD NE
Practice Address - Street 2:BLDG 7-601
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1578
Practice Address - Country:US
Practice Address - Phone:404-842-5400
Practice Address - Fax:404-848-8638
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA4089363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical