Qualizza, Austin Tyler

Qualizza, Austin Tyler is an individual health care provider with primary practice located at 601 Gateway Blvd N , Chesterton IN 46304-9658. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Qualizza, Austin Tyler can be contacted via phone (219) 921-1444.

Contact Information

Primary practice address
601 Gateway Blvd N Chesterton IN 46304-9658
Phone: (219) 921-1444
Fax: (219) 921-5303
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 10003133 Indiana

Profile Details

NPI number 1639778970
LBN Legal business name Qualizza, Austin Tyler
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2020
Last updated May 5th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639778970 NPPES
Indiana MEDICAID 300046175

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