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Organization
IOWA EYE INSTITUTE PC
Active
Organization
IOWA EYE INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS D GORDY MD (PRESIDENT)
(712) 262-8878
Entity
Organization
Contact information
Practice address
1721 W 18TH ST, SPENCER, IA 51301-2827
(712) 262-8878
(712) 262-8807
Mailing address
PO BOX 420, 1721 W 18TH ST, SPENCER, IA 51301-0420
(712) 262-8878
(712) 262-8807
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0610048
—
IA
01
—
61004
WELLMARK
IA
Enumeration date
07/19/2005
Last updated
09/27/2011
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