# ASSOCIATES IN DERMATOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104018472
- **Authorized official:** RICHARD T AMELN (PHYSICIAN)
- **Authorized official phone:** (641) 683-3195

## Contact information

- **Practice address:** 1005 PENNSYLVANIA AVE, OTTUMWA, IA 52501-6413
- **Practice address phone:** (641) 683-3195
- **Mailing address:** 1005 PENNSYLVANIA AVE, OTTUMWA, IA 52501-6413
- **Mailing address phone:** (641) 683-3195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2007
- **Last updated:** 08/10/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0420471 | — | IA |