Healthcare Provider Details

I. General information

NPI: 1891027603
Provider Name (Legal Business Name): ALLERGY AND ASTHMA ASSOCIATES OF THE MISSISSIPPI VALLEY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 03/16/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 E 38TH ST
DAVENPORT IA
52807-1135
US

IV. Provider business mailing address

2112 E 38TH ST
DAVENPORT IA
52807-1135
US

V. Phone/Fax

Practice location:
  • Phone: 563-359-0324
  • Fax: 563-359-9409
Mailing address:
  • Phone: 563-359-0324
  • Fax: 563-359-9409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number26115
License Number StateIA

VIII. Authorized Official

Name: ANDREA LYNN JONES
Title or Position: OWNER/PHYSICIAN
Credential:
Phone: 563-359-9409