Individual
GORDON J KATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1134 N MAIN ST STE 3100, BELLEFONTAINE, OH 43311-2379
(937) 592-9799
(937) 592-9789
Mailing address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 592-9799
(937) 592-9789
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
34-00-4520-K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0702850
—
OH
01
—
H864561
MEDICARE
OH
Enumeration date
09/26/2006
Last updated
02/24/2023
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