Healthcare Provider Details

I. General information

NPI: 1326305038
Provider Name (Legal Business Name): KRISTIN A PLICHTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR DEPARTMENT OF RADIATION ONCOLOGY
IOWA CITY IA
52242
US

IV. Provider business mailing address

200 HAWKINS DR DEPARTMENT OF RADIATION ONCOLOGY
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-0581
  • Fax:
Mailing address:
  • Phone: 319-356-0581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD-45411
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: