MEDICARE: MR. WILLIAM HENRY RIKER P.A.

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	363AM0700X	Medical Physician Assistant	01262	IA

General Provider Information

NPI Number	:	1649313727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM HENRY RIKER P.A.

Provider Business Mailing Address
First Line	:	25 NORWOOD CIR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-5024
Country	:	US
Telephone Number	:	319-341-4558
Fax Number	:

Provider Business Practice Location Address
First Line	:	1548 S GILBERT ST
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-4304
Country	:	US
Telephone Number	:	319-248-0178
Fax Number	:

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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