Provider Demographics
NPI:1053503755
Name:STATE UNIVERSITY OF IOWA
Entity Type:Organization
Organization Name:STATE UNIVERSITY OF IOWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROF. OF PEDIATRICS
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-467-5009
Mailing Address - Street 1:100 HAWKINS DR, 247-A CDD
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-356-7027
Mailing Address - Fax:319-356-3715
Practice Address - Street 1:100 HAWKINS DR, 247-A CDD
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-356-7027
Practice Address - Fax:319-356-3715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare