Healthcare Provider Details

I. General information

NPI: 1255715694
Provider Name (Legal Business Name): CALEB ASWEGEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 1ST ST SE
BELMOND IA
50421-1201
US

IV. Provider business mailing address

403 1ST ST SE
BELMOND IA
50421-1201
US

V. Phone/Fax

Practice location:
  • Phone: 641-444-3500
  • Fax: 641-444-5554
Mailing address:
  • Phone: 641-444-3500
  • Fax: 641-444-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number45318
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: