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General NPI Number Information
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NPI Number | 1417905746
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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 | 05/05/2006
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 1003 PENNSYLVANIA AVE
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City | OTTUMWA
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State | IA
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Zip | 52501-2108
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Country | US
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Telephone | 641-682-2514
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Fax | 641-226-5024
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Provider Business Mailing Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR,PATIENT FINANCIAL SERVICES
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Name | PHILIP E ROUDABUSH
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Credential |
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Telephone | 319-384-2334
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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 |
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