Provider Demographics
NPI:1568455483
Name:STOPPELMOOR ENTERPRISES INC
Entity Type:Organization
Organization Name:STOPPELMOOR ENTERPRISES INC
Other - Org Name:TOWNCREST X-RAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:W
Authorized Official - Last Name:STOPPELMOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-351-5556
Mailing Address - Street 1:2405 TOWNCREST DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6631
Mailing Address - Country:US
Mailing Address - Phone:319-351-5556
Mailing Address - Fax:319-351-0416
Practice Address - Street 1:2405 TOWNCREST DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6631
Practice Address - Country:US
Practice Address - Phone:319-351-5556
Practice Address - Fax:319-351-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0081810Medicaid
IA0081810Medicaid