Basic Information
Provider Information
NPI: 1609119791
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUNZ
FirstName: AARON
MiddleName: RICHARD
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR
Address2: DEPT OF FAMILY MEDICINE
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193847000
FaxNumber: 3193847822
Practice Location
Address1: 200 HAWKINS DR
Address2: DEPT OF FAMILY MEDICINE
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193847000
FaxNumber: 3193847822
Other Information
ProviderEnumerationDate: 03/27/2013
LastUpdateDate: 04/11/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XDO-04877IAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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