Healthcare Provider Details

I. General information

NPI: 1982680567
Provider Name (Legal Business Name): DOUGLAS A KATULA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7277 SMITHS MILL RD STE 250
NEW ALBANY OH
43054-8196
US

IV. Provider business mailing address

7277 SMITHS MILL RD STE 250
NEW ALBANY OH
43054-8196
US

V. Phone/Fax

Practice location:
  • Phone: 614-221-3725
  • Fax: 614-221-5613
Mailing address:
  • Phone: 614-221-3725
  • Fax: 614-221-5613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number35.060292
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.060292
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: