Healthcare Provider Details

I. General information

NPI: 1497743298
Provider Name (Legal Business Name): HARRIET J ECHTERNACHT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 SCOTT BLVD
IOWA CITY IA
52240-2907
US

IV. Provider business mailing address

2941 SIERRA CT SW
IOWA CITY IA
52240-8503
US

V. Phone/Fax

Practice location:
  • Phone: 319-339-7472
  • Fax: 319-688-2503
Mailing address:
  • Phone: 319-337-7642
  • Fax: 319-339-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29493
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: