Organization
WESTERN PENNSYLVANIA ORTHOPEDICS AND SPORTS MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IAN KATZ M.D. (ORTHOPEDIC SURGEON / CORP SECRETARY)
(814) 255-6781
Entity
Organization
Contact information
Practice address
236 JAMESWAY RD, EBENSBURG, PA 15931-4207
(814) 255-6781
(814) 255-5716
Mailing address
2 CELESTE DR, JOHNSTOWN, PA 15905-2832
(814) 255-6781
(814) 255-5716
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6000007302
PA
335E00000X
Prosthetic/Orthotic Supplier
6000007302
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000559282
HIGHMARK BLUE SHIELD GROUP PROVIDER NUMBER
PA
05
—
100763638009
—
PA
Enumeration date
04/01/2016
Last updated
04/01/2016
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