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General NPI Number Information
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NPI Number | 1447480660
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Entity Type | Organization
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Legal Business Name | CASADY FAMILY MEDICINE
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 3821 71ST ST STE B
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City | URBANDALE
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State | IA
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Zip | 50322-3259
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Country | US
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Telephone | 515-226-7888
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Fax | 515-237-3979
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Provider Business Mailing Address
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Address Line | 3821 71ST ST STE B
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City | URBANDALE
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State | IA
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Zip | 50322-3259
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Country | US
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Telephone | 515-226-7888
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Fax | 515-237-3979
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Authorized Official
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Title or Position | SOLE MBR
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Name | SUSAN MARGARET CASADY
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Credential | D O
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Telephone | 515-226-7888
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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 | 03230
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License Number State | IA
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