1447242441 NPI number — MARICHRIS ZAHNLE MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447242441 NPI number — MARICHRIS ZAHNLE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAHNLE
Provider First Name:
MARICHRIS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NAVARRO
Provider Other First Name:
MARICHRIS
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447242441
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
312 E ALTA VISTA
Provider Second Line Business Mailing Address:
ORHC CLINICS
Provider Business Mailing Address City Name:
OTTUMWA
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-684-3053
Provider Business Mailing Address Fax Number:
641-683-2855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 PENNSYLVANIA AVE
Provider Second Line Business Practice Location Address:
SUITE 101 ORHC CLINICS
Provider Business Practice Location Address City Name:
OTTUMWA
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-682-8700
Provider Business Practice Location Address Fax Number:
641-683-8266
Provider Enumeration Date:
08/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  35160 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00332436 . This is a "RAILROAD MCRE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1528687 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3528687 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 15248 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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