Healthcare Provider Details

I. General information

NPI: 1053315705
Provider Name (Legal Business Name): LINDA KATHLEEN KATZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 JOHN SUTHERLAND DR STE 3
NICHOLASVILLE KY
40356-2424
US

IV. Provider business mailing address

100 JOHN SUTHERLAND DR STE 3
NICHOLASVILLE KY
40356-2424
US

V. Phone/Fax

Practice location:
  • Phone: 859-881-1400
  • Fax: 859-881-3489
Mailing address:
  • Phone: 859-881-1400
  • Fax: 859-881-3489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35266
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: