Provider Demographics
NPI:1538115100
Name:GASTOENTEROLOGY ASSOCIATES OF IOWA CITY, PC
Entity Type:Organization
Organization Name:GASTOENTEROLOGY ASSOCIATES OF IOWA CITY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-337-5997
Mailing Address - Street 1:540 E JEFFERSON ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2477
Mailing Address - Country:US
Mailing Address - Phone:319-337-5997
Mailing Address - Fax:319-358-2665
Practice Address - Street 1:540 E JEFFERSON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2477
Practice Address - Country:US
Practice Address - Phone:319-337-5997
Practice Address - Fax:319-358-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IACH7580OtherRAILROAD MEDICARE
IACH7580OtherRAILROAD MEDICARE