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Organization
DIAGNOSTIC & INT MED ASSOC PC
Active
Organization
DIAGNOSTIC & INT MED ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY L KRICSFELD MD FACP (PRESIDENT OWNER)
(712) 322-5532
Entity
Organization
Contact information
Practice address
201 RIDGE ST, SUITE 302, COUNCIL BLUFFS, IA 51503-4643
(712) 322-5532
(800) 293-4214
Mailing address
201 RIDGE ST, SUITE 302, COUNCIL BLUFFS, IA 51503-4643
(712) 322-5532
(800) 293-4214
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129437
—
IA
01
—
CP8208
RAILROAD MEDICARE
IA
Enumeration date
05/20/2006
Last updated
11/14/2013
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