MEDICARE: CHRISTOPHER BALTZELL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	083602	IA

General Provider Information

NPI Number	:	1144776998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER BALTZELL PA-C

Provider Business Mailing Address
First Line	:	PO BOX 424
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50302-0424
Country	:	US
Telephone Number	:	515-875-9255
Fax Number	:	515-875-9923

Provider Business Practice Location Address
First Line	:	710 COMMON PL STE 700
Second Line	:
City	:	ADEL
State	:	IA
Zip	:	50003-8044
Country	:	US
Telephone Number	:	515-875-9760
Fax Number	:	515-875-9761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	12/11/2023

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Directions to “ CHRISTOPHER BALTZELL PA-C” Practice Location

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