Healthcare Provider Details

I. General information

NPI: 1619920089
Provider Name (Legal Business Name): IVO BEKAVAC MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 CYCLONE DR STE D
WATERLOO IA
50701-9715
US

IV. Provider business mailing address

PO BOX 2758
WATERLOO IA
50704-2758
US

V. Phone/Fax

Practice location:
  • Phone: 319-243-1270
  • Fax: 319-232-7373
Mailing address:
  • Phone: 319-833-5954
  • Fax: 319-833-5955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number32552
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: