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General NPI Number Information
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NPI Number | 1093726861
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Entity Type | Organization
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Legal Business Name | KURT R. VANDER PLOEG, M.D., P.C.
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 615 WASHINGTON ST
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City | PELLA
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State | IA
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Zip | 50219-1538
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Country | US
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Telephone | 641-628-2222
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Fax | 641-628-2915
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Provider Business Mailing Address
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Address Line | 615 WASHINGTON ST
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City | PELLA
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State | IA
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Zip | 50219-1538
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Country | US
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Telephone | 641-628-2222
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Fax | 641-628-2915
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | DR. KURT RONALD VANDER PLOEG
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Credential | M.D.
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Telephone | 641-628-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20762
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License Number State | IA
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