Provider Demographics
NPI:1922092915
Name:GARNER, ERIC G (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:G
Last Name:GARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 PENNSYLVANIA AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2195
Mailing Address - Country:US
Mailing Address - Phone:641-692-8761
Mailing Address - Fax:641-682-2764
Practice Address - Street 1:1005 PENNSYLVANIA AVE
Practice Address - Street 2:STE 204
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2195
Practice Address - Country:US
Practice Address - Phone:641-692-8761
Practice Address - Fax:641-682-2764
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27209207V00000X
NE18030207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAF15297Medicare UPIN