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General NPI Number Information
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NPI Number | 1831198191
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Entity Type | Organization
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Legal Business Name | IOWA EYE INSTITUTE PC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 1721 W 18TH ST
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City | SPENCER
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State | IA
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Zip | 51301-2827
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Country | US
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Telephone | 712-262-8878
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Fax | 712-262-8807
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Provider Business Mailing Address
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Address Line | PO BOX 420 1721 W 18TH ST
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City | SPENCER
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State | IA
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Zip | 51301-0420
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Country | US
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Telephone | 712-262-8878
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Fax | 712-262-8807
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS D GORDY
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Credential | MD
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Telephone | 712-262-8878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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