Provider Demographics
NPI:1609416817
Name:KIMBALL & BEECHER IOWA CITY PLLC
Entity Type:Organization
Organization Name:KIMBALL & BEECHER IOWA CITY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-235-6287
Mailing Address - Street 1:4015 HURST DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-9035
Mailing Address - Country:US
Mailing Address - Phone:319-235-6287
Mailing Address - Fax:319-232-3171
Practice Address - Street 1:1008 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6628
Practice Address - Country:US
Practice Address - Phone:319-337-2114
Practice Address - Fax:319-232-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental