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General NPI Number Information
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NPI Number | 1548269301
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Entity Type | Organization
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Legal Business Name | NEW CENTURY PHYSICIANS OF IOWA PC
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 800 MERCY DR
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-3128
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Country | US
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Telephone | 712-328-5230
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Fax |
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Provider Business Mailing Address
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Address Line | 4750 HEMPSTEAD STATION DR
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City | KETTERING
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State | OH
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Zip | 45429-5164
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Country | US
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Telephone | 800-875-0136
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Fax | 937-619-4231
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEPHEN G HOLTZCLAW
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Credential | MD
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Telephone | 856-686-4316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 275930
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License Number State | IA
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