Provider Demographics
NPI:1144296914
Name:NEUROLOGICAL ASSOCIATES OF IOWA CITY, PC
Entity type:Organization
Organization Name:NEUROLOGICAL ASSOCIATES OF IOWA CITY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEITSHUSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-338-5451
Mailing Address - Street 1:540 E JEFFERSON ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2477
Mailing Address - Country:US
Mailing Address - Phone:319-338-5451
Mailing Address - Fax:319-338-9366
Practice Address - Street 1:540 E JEFFERSON ST
Practice Address - Street 2:SUITE 105
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2477
Practice Address - Country:US
Practice Address - Phone:319-338-5451
Practice Address - Fax:319-338-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA20070Medicare PIN