Provider Demographics
NPI:1265405807
Name:EYE ASSOCIATES OF IOWA CITY PC
Entity type:Organization
Organization Name:EYE ASSOCIATES OF IOWA CITY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHLADER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-338-9275
Mailing Address - Street 1:1060 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6625
Mailing Address - Country:US
Mailing Address - Phone:319-338-9275
Mailing Address - Fax:319-338-2499
Practice Address - Street 1:1060 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6625
Practice Address - Country:US
Practice Address - Phone:319-338-9275
Practice Address - Fax:319-338-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0130054Medicaid
IA0130054Medicaid
IA0428910001Medicare NSC