Healthcare Provider Details

I. General information

NPI: 1043284169
Provider Name (Legal Business Name): TERRENCE L AUGSPURGER M.D., CHILD PSYCHIAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 N 4TH AVE
MARSHALLTOWN IA
50158-1836
US

IV. Provider business mailing address

9 N 4TH AVE
MARSHALLTOWN IA
50158-1836
US

V. Phone/Fax

Practice location:
  • Phone: 641-752-1585
  • Fax: 641-752-9665
Mailing address:
  • Phone: 641-752-1585
  • Fax: 641-752-9665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number20681
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier05823
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerMEDICARE
# 2
Identifier05823
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerBCBS
# 3
Identifier321119
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerVALUE OPTIONS
# 4
IdentifierIA0105
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerJOHN DEERE/UBH
# 5
Identifier035056
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerHEALTH ALLIANCE
# 6
Identifier0058230
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: