Healthcare Provider Details

I. General information

NPI: 1356781363
Provider Name (Legal Business Name): HASSAN AZIZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HASSAN AZIZ MD

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-467-5303
  • Fax:
Mailing address:
  • Phone: 319-467-5303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD-49966
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR74017
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number158402
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD-49966
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: