Organization
NORTHWEST IOWA UROLOGISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER LESLIE MENDENHALL M.D. (PRESIDENT)
(712) 262-6214
Entity
Organization
Contact information
Practice address
1200 1ST AVE E, SUITE B, SPENCER, IA 51301-4342
(712) 262-6214
(712) 262-6216
Mailing address
1200 1ST AVE E, SUITE B, SPENCER, IA 51301-4342
(712) 262-6214
(712) 262-6216
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
20168
IA
174400000X
Specialist
Primary
24150
IA
332B00000X
Durable Medical Equipment & Medical Supplies
20168
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183244
—
IA
Enumeration date
05/19/2006
Last updated
01/08/2014
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