Organization
RICHARD N SHATZ MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD NELSON SHATZ M.D. (OWNER)
(217) 228-1312
Entity
Organization
Contact information
Practice address
1135 BROADWAY ST, QUINCY, IL 62301-2809
(217) 228-1312
(217) 228-1316
Mailing address
1135 BROADWAY ST, QUINCY, IL 62301-2809
(217) 228-1312
(217) 228-1316
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001410
—
MO
05
—
36107867
—
IL
Enumeration date
04/11/2008
Last updated
04/11/2008
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