Provider Demographics
NPI: | 1770924219 |
---|---|
Name: | UNIVERSITY OF IOWA HOSPITALS AND CLINICS |
Entity type: | Organization |
Organization Name: | UNIVERSITY OF IOWA HOSPITALS AND CLINICS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | FELLOWSHIP PROGRAM DIRECTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | THOMAS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | COLLINS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 319-384-9410 |
Mailing Address - Street 1: | 1165 S RIVERSIDE DR |
Mailing Address - Street 2: | |
Mailing Address - City: | IOWA CITY |
Mailing Address - State: | IA |
Mailing Address - Zip Code: | 52246-5714 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 319-467-5302 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 200 HAWKINS DR |
Practice Address - Street 2: | UIHC - DEPT OF SURGERY |
Practice Address - City: | IOWA CITY |
Practice Address - State: | IA |
Practice Address - Zip Code: | 52242 |
Practice Address - Country: | US |
Practice Address - Phone: | 319-467-5302 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-07-12 |
Last Update Date: | 2013-07-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IA | R9833 | 281P00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 281P00000X | Hospitals | Chronic Disease Hospital |