Individual
BETH E HOTHANZIELINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 S MAIN, FAIRFIELD, IA 52556-9572
(641) 469-4204
(641) 469-4208
Mailing address
2000 S MAIN, FAIRFIELD, IA 52556-9572
(641) 469-4204
(641) 469-4208
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32860
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49167
BLUE CROSS
IA
Enumeration date
01/13/2006
Last updated
05/01/2013
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