| Doctor Name: | MARCO KATADA |
| NPI Number: | 1003224932 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 76331 |
| Business Practice Address: | 1111 E Spruce St Garden City, KS - 678465958 |
| Business Phone Number: | 6202750644 |
| Business Fax Number: | 6202720239 |
| Mailing Address: | Po Box 531, GARDEN CITY |
| State: | KS |
| Postal Code: | 678460531 |
| Phone Number: | 6202750644 |
| Fax Number: | 6202720239 |
| NPI Enumeration Date: | 07/23/2014 |
| NPI Last Update Date: | 07/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 76331 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |