Provider Demographics
NPI:1649261561
Name:DUBUQUE UROLOGY SERVICE, P.C.
Entity type:Organization
Organization Name:DUBUQUE UROLOGY SERVICE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, DUBUQUE UROLOGY SEVICE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:VOELKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-557-5971
Mailing Address - Street 1:1500 DELHI ST
Mailing Address - Street 2:SUITE 4300 PO BOX 838
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52004-0838
Mailing Address - Country:US
Mailing Address - Phone:563-557-5971
Mailing Address - Fax:563-557-5973
Practice Address - Street 1:1500 DELHI ST
Practice Address - Street 2:SUITE 4300
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6358
Practice Address - Country:US
Practice Address - Phone:563-557-5971
Practice Address - Fax:563-557-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0150946Medicaid
IA51578OtherBLUE CROSS/BLUE SHIELD IA
IA=========-00OtherUNITY
IA0150946Medicaid