Healthcare Provider Details

I. General information

NPI: 1568455483
Provider Name (Legal Business Name): STOPPELMOOR ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 TOWNCREST DR
IOWA CITY IA
52240-6631
US

IV. Provider business mailing address

2405 TOWNCREST DR
IOWA CITY IA
52240-6631
US

V. Phone/Fax

Practice location:
  • Phone: 319-351-5556
  • Fax: 319-351-0416
Mailing address:
  • Phone: 319-351-5556
  • Fax: 319-351-0416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ERNEST W STOPPELMOOR
Title or Position: PRESIDENT
Credential:
Phone: 319-351-5556