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NPI Code Detail

MEDICARE: AUSTIN T GRANATOWICZ MD

MEDICARE:   AUSTIN T GRANATOWICZ  MD
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
1207Q00000XFamily Medicine Physician35721NE

General Provider Information

NPI Number : 1184240533
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUSTIN T GRANATOWICZ MD
Provider Business Mailing Address
First Line : 814 PIERCE ST STE 300
Second Line :
City : SIOUX CITY
State : IA
Zip : 51101-1058
Country : US
Telephone Number : 712-226-2600
Fax Number : 712-226-2605
Provider Business Practice Location Address
First Line : 3250 PLAZA DR
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3144
Country : US
Telephone Number : 402-412-4220
Fax Number : 402-494-1365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2020
Last Update Date : 12/05/2025

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Directions to “ AUSTIN T GRANATOWICZ MD” Practice Location

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