Provider Demographics
NPI:1447242441
Name:ZAHNLE, MARICHRIS (MD)
Entity Type:Individual
Prefix:
First Name:MARICHRIS
Middle Name:
Last Name:ZAHNLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARICHRIS
Other - Middle Name:
Other - Last Name:NAVARRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:312 E ALTA VISTA
Mailing Address - Street 2:ORHC CLINICS
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501
Mailing Address - Country:US
Mailing Address - Phone:641-684-3053
Mailing Address - Fax:641-683-2855
Practice Address - Street 1:1005 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 101 ORHC CLINICS
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501
Practice Address - Country:US
Practice Address - Phone:641-682-8700
Practice Address - Fax:641-683-8266
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35160208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00332436OtherRAILROAD MCRE
IA1528687Medicaid
IA3528687Medicaid
15248OtherBCBS
IAI17694Medicare PIN
15248OtherBCBS
IAG87391Medicare UPIN