Provider Demographics
NPI:1063588325
Name:KATZ, SUSAN CAMPBELL (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:CAMPBELL
Last Name:KATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2980 E VIA ALCALDE STREET
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5000
Mailing Address - Country:US
Mailing Address - Phone:520-320-5030
Mailing Address - Fax:520-320-5025
Practice Address - Street 1:2980 E VIA ALCALDE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5000
Practice Address - Country:US
Practice Address - Phone:520-320-5030
Practice Address - Fax:520-320-5025
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ242732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZA64344Medicare UPIN