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NPI Code Detail

MEDICARE: SPRING PARK SURGERY CENTER L L C

MEDICARE: SPRING PARK SURGERY CENTER L L C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/CenterIA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3490004256OTHERIAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
261015OTHERIAWELLMARK BCBS

General Provider Information

NPI Number : 1073516795
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING PARK SURGERY CENTER L L C
Provider Business Mailing Address
First Line : 3319 SPRING ST
Second Line : STE 202A
City : DAVENPORT
State : IA
Zip : 52807-2125
Country : US
Telephone Number : 563-355-6236
Fax Number : 563-359-4634
Provider Business Practice Location Address
First Line : 3319 SPRING ST
Second Line : STE 202A
City : DAVENPORT
State : IA
Zip : 52807-2125
Country : US
Telephone Number : 563-355-6236
Fax Number : 563-359-4634
Authorized Official
Title or Position : BUSINESS OFFICE MANAGER
Name : KATRINA MAE MASAKOWSKI
Credential :
Telephone Number : 563-359-1716
Provider Enumeration Date : 05/27/2005
Last Update Date : 11/30/2011

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1912900820 — DR. DAVID PAUL ROHLF M.D.
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1437152162 — DR. PAUL LEON ROHLF M.D.
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Practice Fax: 563-359-4634
1538162250 — DR. MARK ARTHUR MILLEMAN M.D.
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1346229192 — UROLOGICAL ASSOCIATES PC
Practice Location Address:
3319 SPRING ST STE 202
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Practice Fax: 563-359-4634

Directions to “SPRING PARK SURGERY CENTER L L C ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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