Healthcare Provider Details

I. General information

NPI: 1962472068
Provider Name (Legal Business Name): FLOYD COUNTY HOSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 10/07/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 11TH ST
CHARLES CITY IA
50616-3468
US

IV. Provider business mailing address

800 11TH ST
CHARLES CITY IA
50616-3468
US

V. Phone/Fax

Practice location:
  • Phone: 641-228-6830
  • Fax: 641-257-4336
Mailing address:
  • Phone: 641-228-6830
  • Fax: 641-257-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number340138H
License Number StateIA

VIII. Authorized Official

Name: DAWNETT WILLIS
Title or Position: CEO
Credential:
Phone: 641-228-6830