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Organization

PATHOLOGY MEDICAL SERVICES OF SIOUXLAND PC

Active
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Organization

PATHOLOGY MEDICAL SERVICES OF SIOUXLAND PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL TODD KAFKA M.D. (PRESIDENT)
(712) 279-3226
Entity
Organization

Contact information

Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3226
(712) 279-7034
Mailing address
PO BOX 100559, FLORENCE, SC 29501-0559
(843) 664-4300
(843) 664-4308

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
23374
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0175448
—
IA
01
—
32972
BCBS GRP#
IA
Enumeration date
04/04/2006
Last updated
01/15/2008
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