Healthcare Provider Details

I. General information

NPI: 1225082712
Provider Name (Legal Business Name): DIANA K KATT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 COMMERCIAL CIR
WAMEGO KS
66547-9690
US

IV. Provider business mailing address

1704 COMMERCIAL CIR
WAMEGO KS
66547-9690
US

V. Phone/Fax

Practice location:
  • Phone: 785-456-2207
  • Fax:
Mailing address:
  • Phone: 785-456-2207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-20161
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: