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General NPI Number Information
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NPI Number | 1639593858
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Entity Type | Organization
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Legal Business Name | JOSEPH J KATTA MD, PA
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 1811 S 25TH ST
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City | FORT PIERCE
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State | FL
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Zip | 34947-4756
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Country | US
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Telephone | 772-595-5988
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Fax | 772-595-5989
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Provider Business Mailing Address
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Address Line | 1811 S 25TH ST
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City | FORT PIERCE
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State | FL
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Zip | 34947-4756
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Country | US
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Telephone | 772-595-5988
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Fax | 772-595-5989
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Authorized Official
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Title or Position | CHIEF OFFICER
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Name | JOSEPH J KATTA
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Credential | MD
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Telephone | 772-595-5988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 047323
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License Number State | FL
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