Provider Demographics
NPI:1134108806
Name:DUBUQUE PEDIATRICS PC
Entity Type:Organization
Organization Name:DUBUQUE PEDIATRICS PC
Other - Org Name:FRANZEN KEMP AND MCGILL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEEVIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FRANZEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-557-5911
Mailing Address - Street 1:1500 DELHI ST
Mailing Address - Street 2:SUITE 3500
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6358
Mailing Address - Country:US
Mailing Address - Phone:563-557-5911
Mailing Address - Fax:563-557-5910
Practice Address - Street 1:1500 DELHI ST
Practice Address - Street 2:SUITE 3500
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6321
Practice Address - Country:US
Practice Address - Phone:563-557-5911
Practice Address - Fax:563-557-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0224675Medicaid
IAN33OtherDEAN HEALTH PLAN
IA22467OtherWELLMARK BCBS OF IOWA