MEDICARE: CARLA J SPRINGER M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	R7503	IA
2	207Q00000X	Family Medicine Physician	37633	IA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00819893	OTHER	IA	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1356382923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA J SPRINGER M.D.

Provider Business Mailing Address
First Line	:	1015 S HACKETT RD
Second Line	:	SUITE 100
City	:	WATERLOO
State	:	IA
Zip	:	50701-3500
Country	:	US
Telephone Number	:	319-374-1000
Fax Number	:	319-292-6526

Provider Business Practice Location Address
First Line	:	1015 S HACKETT RD
Second Line	:	SUITE 100
City	:	WATERLOO
State	:	IA
Zip	:	50701-3500
Country	:	US
Telephone Number	:	319-274-1000
Fax Number	:	319-292-6526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	10/31/2011

1015 S HACKETT RD , SUITE 200
WATERLOO, IA
50701-3500

Practice Phone: 319-266-5491
Practice Fax: 319-266-6687