Basic Information
Provider Information
NPI: 1003805847
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KATZ
FirstName: TORY
MiddleName: BETH
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: BOZEMAN HEALTH DEACONESS HOSPITAL
Address2: 915 HIGHLAND BLVD
City: BOZEMAN
State: MT
PostalCode: 597156902
CountryCode: US
TelephoneNumber: 4064145000
FaxNumber:  
Practice Location
Address1: 915 HIGHLAND BLVD
Address2:  
City: BOZEMAN
State: MT
PostalCode: 597156902
CountryCode: US
TelephoneNumber: 4055515050
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/14/2005
LastUpdateDate: 02/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X12164MTN Allopathic & Osteopathic PhysiciansInternal Medicine 
208000000X12164MTN Allopathic & Osteopathic PhysiciansPediatrics 
208M00000X12164MTY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
68988805AZ MEDICAID
4247822705CO MEDICAID
0377278105NM MEDICAID


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