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NPI Code Detail

MEDICARE: MR. DENNIS D BOEKHOFF DO

MEDICARE: MR. DENNIS D BOEKHOFF DO
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
1207P00000XEmergency Medicine Physician01536IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
218563OTHERMIDLANDS CHOICE
338202OTHERWELLMARK BCBS OF IOWA

General Provider Information

NPI Number : 1992765333
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS D BOEKHOFF DO
Provider Business Mailing Address
First Line : PO BOX 643440
Second Line :
City : CINCINNATI
State : OH
Zip : 45264-0001
Country : US
Telephone Number : 800-299-8464
Fax Number :
Provider Business Practice Location Address
First Line : 1410 N 4TH ST
Second Line :
City : CLINTON
State : IA
Zip : 52732-2940
Country : US
Telephone Number : 563-244-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 01/22/2008

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