Healthcare Provider Details

I. General information

NPI: 1487978359
Provider Name (Legal Business Name): MATTHEW SAMUEL JOSEPH KATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 01/28/2020
Certification Date: 01/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 22ND AVE N
NASHVILLE TN
37203
US

IV. Provider business mailing address

PO BOX 158281
NASHVILLE TN
37215-8281
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-2001
  • Fax: 615-234-2015
Mailing address:
  • Phone: 615-306-1075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD455934
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0077731
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number56785
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: