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Organization
OB-GYN SPECIALISTS, P.C.
Active
Organization
OB-GYN SPECIALISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS L. STANFORD M.D. (MANAGING PARTNER)
(319) 234-5764
Entity
Organization
Contact information
Practice address
432 KING DR, WATERLOO, IA 50702-5956
(319) 234-5764
(319) 234-1336
Mailing address
432 KING DR, WATERLOO, IA 50702-5956
(319) 234-5764
(319) 234-1336
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0184473
—
IA
01
—
26933
BC/BS GROUP NUMBER
—
01
—
CP8715
RAILROAD MEDICARE
—
Enumeration date
07/07/2005
Last updated
12/01/2008
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