MEDICARE: KATY WILTZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	MD2016-0964	NM
2	207N00000X	Dermatology Physician	MD.202130	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619168846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATY WILTZ MD

Provider Business Mailing Address
First Line	:	2633 NAPOLEON AVE STE 1020
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-7403
Country	:	US
Telephone Number	:	504-891-8004
Fax Number	:

Provider Business Practice Location Address
First Line	:	2633 NAPOLEON AVE STE 1020
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-7403
Country	:	US
Telephone Number	:	504-891-8004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	04/06/2021

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Directions to “ KATY WILTZ MD” Practice Location

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