Healthcare Provider Details

I. General information

NPI: 1952489148
Provider Name (Legal Business Name): ROY E METZGER JR. ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 02/03/2011
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 TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberH-066712
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH-066712
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: