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General NPI Number Information
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NPI Number | 1285694497
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Entity Type | Individual
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Provider Name | ERIC E LUEBBERT D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 701 E 2ND ST
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City | IDA GROVE
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State | IA
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Zip | 51445-1699
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Country | US
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Telephone | 712-364-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 UNIVERSITY AVE STE 104
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City | WEST DES MOINES
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State | IA
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Zip | 50266-5945
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Country | US
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Telephone | 515-226-7426
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Fax | 515-226-8506
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 3363
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License Number State | IA
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