Individual
DR. CARLTON ROBERT FENZL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 TANGLEFOOT LN, BETTENDORF, IA 52722-1650
(563) 323-2020
(563) 459-6615
Mailing address
777 TANGLEFOOT LN, BETTENDORF, IA 52722-1650
(563) 323-2020
(563) 459-6615
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036.137712
IL
207W00000X
Ophthalmology Physician
Primary
42474
IA
207WX0120X
Cornea and External Diseases Specialist Physician
036.137712
IL
207WX0120X
Cornea and External Diseases Specialist Physician
42474
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036137712
—
IL
05
—
1386958064
—
IA
Enumeration date
08/04/2010
Last updated
03/18/2021
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