Provider Demographics
NPI:1467666172
Name:DR. JOHN A. VAUBEL, P.C.
Entity Type:Organization
Organization Name:DR. JOHN A. VAUBEL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-732-5030
Mailing Address - Street 1:620 NORTHWESTERN DR
Mailing Address - Street 2:BOX 634
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-2935
Mailing Address - Country:US
Mailing Address - Phone:712-732-5030
Mailing Address - Fax:712-213-5031
Practice Address - Street 1:620 NORTHWESTERN DR
Practice Address - Street 2:BOX 634
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-2935
Practice Address - Country:US
Practice Address - Phone:712-732-5030
Practice Address - Fax:712-213-5031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23567207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1203687Medicaid
IA1203687Medicaid
IAA02181Medicare UPIN
IAI7619Medicare PIN