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General NPI Number Information
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NPI Number | 1104295823
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Entity Type | Organization
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Legal Business Name | STATE UNIVERSITY OF IOWA
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 411 LAUREL ST SUITE 300A
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City | DES MOINES
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State | IA
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Zip | 50314-3017
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Country | US
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Telephone | 515-247-3970
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Fax | 515-663-8819
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Provider Business Mailing Address
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Address Line | 411 LAUREL ST STE A300
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City | DES MOINES
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State | IA
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Zip | 50314-3030
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Country | US
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Telephone | 515-282-2921
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Fax | 515-663-8819
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Authorized Official
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Title or Position | SR DIRECTOR OF GOVT REIMBURSEMENT
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Name | MR. JOE M MCKELVEY JR.
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Credential |
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Telephone | 319-467-8549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | IA
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