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General NPI Number Information
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NPI Number | 1497923163
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Entity Type | Organization
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Legal Business Name | MID IOWA ORTHOPAEDICS, P.C.
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 300 N 4TH AVE E SUITE 140B
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City | NEWTON
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State | IA
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Zip | 50208-3155
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Country | US
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Telephone | 641-787-9276
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Fax |
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Provider Business Mailing Address
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Address Line | 300 N 4TH AVE E SUITE 140B
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City | NEWTON
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State | IA
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Zip | 50208-3155
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Country | US
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Telephone | 641-787-9276
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD WILLIAM CHARLES
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Credential | M.D.
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Telephone | 641-787-9276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 27934
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License Number State | IA
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