MEDICARE: JULIE L. VAILS M.D.

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	207Q00000X	Family Medicine Physician	A749521	CA
2	207VX0000X	Obstetrics Physician	A749521	CA
3	208000000X	Pediatrics Physician	A749521	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00051481	OTHER	CA	MEDICARE RAIL ROAD

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	034433	OTHER	CA	HILL PHYSICIANS MED GROUP
3	710908889	OTHER	CA	SUTTER MEDICAL GROUP

General Provider Information

NPI Number	:	1730156902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE L. VAILS M.D.

Provider Business Mailing Address
First Line	:	1322 SHOREWAY RD
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-3016
Country	:	US
Telephone Number	:	712-213-1322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1322 SHOREWAY RD
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-3016
Country	:	US
Telephone Number	:	712-213-1322
Fax Number	:

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	11/19/2010

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Directions to “ JULIE L. VAILS M.D.” Practice Location

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