Provider Demographics
NPI:1922593706
Name:DOTZLER, RICHARD L JR (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:DOTZLER
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 CHATBURN PLZ
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537-1980
Mailing Address - Country:US
Mailing Address - Phone:712-755-2101
Mailing Address - Fax:712-755-5576
Practice Address - Street 1:1812 CHATBURN PLZ
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-1980
Practice Address - Country:US
Practice Address - Phone:712-755-2101
Practice Address - Fax:712-755-5576
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist