Provider Demographics
NPI:1275645343
Name:NEUROSURGERY OF NORTH IOWA, P.C.
Entity Type:Organization
Organization Name:NEUROSURGERY OF NORTH IOWA, P.C.
Other - Org Name:NEUROLOGICAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-422-7847
Mailing Address - Street 1:1010 4TH ST SW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2857
Mailing Address - Country:US
Mailing Address - Phone:641-494-3041
Mailing Address - Fax:641-494-3059
Practice Address - Street 1:1010 4TH ST SW
Practice Address - Street 2:SUITE 105
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2857
Practice Address - Country:US
Practice Address - Phone:641-422-7847
Practice Address - Fax:641-422-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42991OtherWELLMARK
IA0435545Medicaid
IA0435545Medicaid