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General NPI Number Information
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NPI Number | 1184629073
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Entity Type | Organization
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Legal Business Name | IOWA PHYSICIANS
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 405 S CLARK ST STE 200
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City | CARROLL
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State | IA
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Zip | 51401-3047
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Country | US
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Telephone | 712-792-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 405 S CLARK ST STE 200
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City | CARROLL
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State | IA
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Zip | 51401-3047
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Country | US
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Telephone | 712-792-0040
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. ERIC L PAULSON
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Credential |
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Telephone | 712-792-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number | 22537
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License Number State | IA
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