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General NPI Number Information
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NPI Number | 1730705385
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Entity Type | Organization
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Legal Business Name | IOWA DERMATOLOGY CONSULTANTS, PLLC
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 05/23/2021
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Provider Practice Location Address
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Address Line | 2675 N ANKENY BLVD STE 101
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City | ANKENY
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State | IA
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Zip | 50023-4719
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Country | US
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Telephone | 515-217-4807
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Fax | 515-257-6977
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Provider Business Mailing Address
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Address Line | 2675 N ANKENY BLVD STE 101
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City | ANKENY
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State | IA
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Zip | 50023-4719
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Country | US
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Telephone | 515-217-4807
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Fax | 515-257-6977
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Authorized Official
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Title or Position | DERMATOLOGIST/OWNER
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Name | DR. KATRINA ANN SMITH
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Credential | MD
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Telephone | 715-581-5713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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