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NPI Code Detail

MEDICARE: STATE UNIVERSITY OF IOWA

MEDICARE: STATE UNIVERSITY OF IOWA
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 Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CK8848OTHERIARR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1194773606
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE UNIVERSITY OF IOWA
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 9TH AVE
Second Line :
City : BELLE PLAINE
State : IA
Zip : 52208-2200
Country : US
Telephone Number : 319-444-3210
Fax Number : 319-444-4099
Authorized Official
Title or Position : DIRECTOR, PATIENT FINANCIAL SERVICE
Name : PHILIP E ROUDABUSH
Credential :
Telephone Number : 319-384-2334
Provider Enumeration Date : 05/05/2006
Last Update Date : 03/01/2012

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Directions to “STATE UNIVERSITY OF IOWA ” Practice Location

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