Provider Demographics
NPI:1720557614
Name:SIOUXLAND DIAGNOSTIC PATHOLOGY SERVICES, PLLC
Entity Type:Organization
Organization Name:SIOUXLAND DIAGNOSTIC PATHOLOGY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-319-6399
Mailing Address - Street 1:801 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1326
Mailing Address - Country:US
Mailing Address - Phone:712-279-2052
Mailing Address - Fax:
Practice Address - Street 1:801 5TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1326
Practice Address - Country:US
Practice Address - Phone:712-279-2052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1174722854Medicaid
IA1104023191Medicaid
IA1417931072Medicaid