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General NPI Number Information
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NPI Number | 1457556656
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Entity Type | Individual
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Provider Name | DAVID JOEL KATZELNICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5452
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Country | US
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Telephone | 480-301-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 200 1ST ST SW # ARZ
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City | ROCHESTER
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State | MN
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Zip | 55905-0001
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Country | US
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Telephone | 480-301-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 52993
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 53596
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 31456
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 105171
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License Number State | MN
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