Provider Demographics
NPI:1992983209
Name:KINZEL, CARL J (DO)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:J
Last Name:KINZEL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2545 CAPITAL AVE SW STE 201
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7103
Mailing Address - Country:US
Mailing Address - Phone:269-224-6190
Mailing Address - Fax:269-339-3044
Practice Address - Street 1:2545 CAPITAL AVE SW STE 201
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7103
Practice Address - Country:US
Practice Address - Phone:269-224-6190
Practice Address - Fax:269-339-3044
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2024-08-12
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Provider Licenses
StateLicense IDTaxonomies
MI5101016936207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3403789Medicare PIN