Provider Demographics
NPI:1952346736
Name:QUENTZEL, PAUL S (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:QUENTZEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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:STE 101
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:2006-06-17
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24503174400000X
IA36932207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0733451Medicaid
IA27841OtherBCBS
IAP00348492OtherRMCRE RAILROAD MEDICARE
IAD27241Medicare UPIN
IAI18508Medicare PIN
IA27841OtherBCBS