Healthcare Provider Details

I. General information

NPI: 1588600548
Provider Name (Legal Business Name): ARCHANA TIRATH LAROIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARCHANA KUMARI

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
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: 319-356-3375
  • Fax: 319-356-2220
Mailing address:
  • Phone: 319-356-3375
  • Fax: 319-356-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number36570
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: