MEDICARE: STATE UNIVERSITY OF IOWA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1000X	Student Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	08977	OTHER	IA	WELLMARK BC/BS

General Provider Information

NPI Number	:	1285635664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATE UNIVERSITY OF IOWA

Provider Business Mailing Address
First Line	:	4189 WL UNIVERSITY OF IOWA
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1100
Country	:	US
Telephone Number	:	319-335-8376
Fax Number	:	319-335-7247

Provider Business Practice Location Address
First Line	:	4189 WL UNIVERSITY OF IOWA
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1100
Country	:	US
Telephone Number	:	319-335-8376
Fax Number	:	319-335-7247

Authorized Official
Title or Position	:	DIRECTOR STUDENT HEALTH SERVICE
Name	:	JAMES KELLOGG
Credential	:
Telephone Number	:	319-384-1135

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	05/09/2013

Similar Medicare Providers

1841293354 — KEITH BRYAN GUESS PA
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 319-335-7247

1538153457 — DR. BARBARA L. PATRICK M.D.
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 319-335-7247

1902892250 — JOY M HUDSON MD
Practice Location Address:

4189 WESTLAWN ST , UNIVERSITY OF IOWA STUDENT HEALTH SERVICES
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 319-335-7247

1740276096 — MARY LEROY KHOWASSAH MD
Practice Location Address:

4189 WESTLAWN S , UNIVERSITY OF IOWA STUDENT HEALTH SERVICES
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 319-335-7247

1730175571 — ERIC R EVANS MD
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-353-5959
Practice Fax: 319-335-7247

1568459188 — MARY F HACKER MD
Practice Location Address:

4189 WESTLAWN S
IOWA CITY, IA
52242-1100

Practice Phone: 319-335-8370
Practice Fax: 314-335-7247

Directions to “STATE UNIVERSITY OF IOWA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.