Provider Demographics
NPI:1114411402
Name:FARRUGGIA, JULIA T (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:T
Last Name:FARRUGGIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:T
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6400 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324
Mailing Address - Country:US
Mailing Address - Phone:515-274-3551
Mailing Address - Fax:
Practice Address - Street 1:6400 HICKMAN RD.
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324
Practice Address - Country:US
Practice Address - Phone:515-274-3551
Practice Address - Fax:515-274-3512
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-11357207Q00000X
IAMD-46615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine