Healthcare Provider Details

I. General information

NPI: 1780687657
Provider Name (Legal Business Name): SKIFF MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N 4TH AVE E
NEWTON IA
50208-3135
US

IV. Provider business mailing address

204 N 4TH AVE E
NEWTON IA
50208-3135
US

V. Phone/Fax

Practice location:
  • Phone: 641-792-1273
  • Fax: 641-791-4852
Mailing address:
  • Phone: 641-792-1273
  • Fax: 641-791-4852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number500041H
License Number StateIA

VIII. Authorized Official

Name: BRETT A ALTMAN
Title or Position: CEO
Credential:
Phone: 641-792-1273