Basic Information
| Provider Information | |||||||||
| NPI: | 1023307170 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAPPELLE | ||||||||
| FirstName: | QUINTIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 1ST ST SW | ||||||||
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| City: | ROCHESTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 559050001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6087850940 | ||||||||
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| Practice Location | |||||||||
| Address1: | 191 THEATER RD | ||||||||
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| City: | ONALASKA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546508679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6083925000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2011 | ||||||||
| LastUpdateDate: | 09/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 61264 | MN | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 66058 | WI | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.