Provider Demographics
NPI:1831143510
Name:RIVER CITIES OPHTHALMOLOGY, P.C.
Entity Type:Organization
Organization Name:RIVER CITIES OPHTHALMOLOGY, P.C.
Other - Org Name:JONATHAN CUTLER M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-372-9292
Mailing Address - Street 1:5409 AVENUE O
Mailing Address - Street 2:SUITE 118
Mailing Address - City:FORT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627-9601
Mailing Address - Country:US
Mailing Address - Phone:319-372-9292
Mailing Address - Fax:319-372-3025
Practice Address - Street 1:5409 AVENUE O
Practice Address - Street 2:SUITE 118
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-9601
Practice Address - Country:US
Practice Address - Phone:319-372-9292
Practice Address - Fax:319-372-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0429787Medicaid
IAI7611Medicare ID - Type UnspecifiedIOWA MEDICARE GROUP
IACE9600Medicare ID - Type UnspecifiedRAILROAD MEDICARE GROUP