Provider Demographics
NPI:1972533917
Name:INTERNAL MEDICINE CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:641-782-6440
Mailing Address - Street 1:1700 W TOWNLINE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-1054
Mailing Address - Country:US
Mailing Address - Phone:641-782-6440
Mailing Address - Fax:641-782-6515
Practice Address - Street 1:1700 W TOWNLINE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1054
Practice Address - Country:US
Practice Address - Phone:641-782-6440
Practice Address - Fax:641-782-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02185207R00000X
IA001293363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA02185OtherIOWA LICENSE NUMBER
IA1031757Medicaid
IA001293OtherIOWA LICENSE NUMBER
D89651Medicare UPIN
00810Medicare ID - Type Unspecified
IA02185OtherIOWA LICENSE NUMBER