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General NPI Number Information
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NPI Number | 1700870649
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Entity Type | Organization
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Legal Business Name | OBSTETRIC AND GYNECOLOGIC ASSOCIATES OF IOWA CITY PC
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 2769 HEARTLAND DR SUITE 201
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City | CORALVILLE
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State | IA
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Zip | 52241-2732
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Country | US
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Telephone | 319-337-3193
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Fax | 319-545-4570
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Provider Business Mailing Address
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Address Line | 2769 HEARTLAND DR SUITE 201
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City | CORALVILLE
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State | IA
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Zip | 52241-2732
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Country | US
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Telephone | 319-337-3193
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Fax | 319-545-4570
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Authorized Official
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Title or Position | PRESIDENT
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Name | LORI S WENZEL
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Credential | M.D.
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Telephone | 319-337-3193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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