Healthcare Provider Details

I. General information

NPI: 1699756320
Provider Name (Legal Business Name): HOWARD KATZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 N STATE ST SUITE 202
JACKSON MS
39202-2413
US

IV. Provider business mailing address

1190 N STATE ST SUITE 202
JACKSON MS
39202-2413
US

V. Phone/Fax

Practice location:
  • Phone: 601-968-0894
  • Fax: 601-968-0896
Mailing address:
  • Phone: 601-968-0894
  • Fax: 601-968-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: