Provider Demographics
NPI:1033402375
Name:FILIPIAK, TRISHIA A (MD)
Entity Type:Individual
Prefix:
First Name:TRISHIA
Middle Name:A
Last Name:FILIPIAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S STORY ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-4739
Mailing Address - Country:US
Mailing Address - Phone:515-432-4444
Mailing Address - Fax:
Practice Address - Street 1:120 S STORY ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036-4739
Practice Address - Country:US
Practice Address - Phone:515-432-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-41903207Q00000X
WI59929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1033402375Medicaid
IAP01364298OtherRR MEDICARE
IAP01364298OtherRR MEDICARE