# WELLENDORF ENT, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740494244
- **Authorized official:** DR. TRACEY G WELLENDORF M.D. (PRESIDENT)
- **Authorized official phone:** (712) 792-4368

## Contact information

- **Practice address:** 405 S CLARK ST, SUITE 215, CARROLL, IA 51401-3065
- **Practice address phone:** (712) 792-4368
- **Practice address fax:** (712) 792-2056
- **Mailing address:** PO BOX 766, CARROLL, IA 51401-0766
- **Mailing address phone:** (712) 792-4368
- **Mailing address fax:** (712) 792-4351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 30594 | IA | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 03/26/2019