MEDICARE: RICKIE D DESCAMPS DO

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	207P00000X	Emergency Medicine Physician	1858	IA

General Provider Information

NPI Number	:	1982692422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICKIE D DESCAMPS DO

Provider Business Mailing Address
First Line	:	1509 W JACKSON ST
Second Line	:
City	:	KNOXVILLE
State	:	IA
Zip	:	50138-1008
Country	:	US
Telephone Number	:	641-828-7556
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 W JACKSON ST
Second Line	:
City	:	KNOXVILLE
State	:	IA
Zip	:	50138-1008
Country	:	US
Telephone Number	:	641-828-7556
Fax Number	:

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	07/08/2007

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