Provider Demographics
NPI:1699756320
Name:KATZ, HOWARD
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 N STATE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-2413
Mailing Address - Country:US
Mailing Address - Phone:601-968-0894
Mailing Address - Fax:601-968-0896
Practice Address - Street 1:1190 N STATE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2413
Practice Address - Country:US
Practice Address - Phone:601-968-0894
Practice Address - Fax:601-968-0896
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC03077OtherMEDICARE GROUP
MS250000045Medicare PIN