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General NPI Number Information
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NPI Number | 1679543458
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Entity Type | Individual
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Provider Name | PETER LEE KATZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 1109 E REELFOOT AVE SUITE A
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City | UNION CITY
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State | TN
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Zip | 38261-5856
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Country | US
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Telephone | 731-886-8441
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 405827
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City | ATLANTA
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State | GA
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Zip | 30384-5827
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Country | US
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Telephone | 870-934-5821
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Fax | 870-934-5384
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25151
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 44832
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License Number State | TN
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