Individual
TARA KATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
612 N ANDOVER RD, ANDOVER, KS 67002-9778
(316) 733-6618
(316) 733-5299
Mailing address
612 N ANDOVER RD, ANDOVER, KS 67002-9778
(316) 733-6618
(316) 733-5299
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-36048
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201072060A
—
KS
Enumeration date
05/17/2010
Last updated
06/10/2016
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