Provider Demographics
NPI:1194946707
Name:PLATZ, PAUL B (PA-C)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:B
Last Name:PLATZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 CAISSON HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-5037
Mailing Address - Country:US
Mailing Address - Phone:785-239-7155
Mailing Address - Fax:785-239-7364
Practice Address - Street 1:600 CAISSON HILL ROAD
Practice Address - Street 2:
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-5037
Practice Address - Country:US
Practice Address - Phone:785-239-7155
Practice Address - Fax:785-239-7364
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9109534363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant