Provider Demographics
NPI:1033523931
Name:DAVICK, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:DAVICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:LEICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DRIVE
Mailing Address - Street 2:DEPARTMENT OF CARDIOTHORACIC SURGERY
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-4518
Mailing Address - Fax:319-356-3891
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPT. OF GENERAL SURGERY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-6425
Practice Address - Fax:319-356-8682
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10109208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery