Individual
DR. LANI JOELLE TAN GO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 PENNSYLVANIA AVE, OTTUMWA, IA 52501-6427
(641) 684-2300
Mailing address
101 S MARKET ST, SUITE 501, OTTUMWA, IA 52501
(609) 907-5562
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
57.024298
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2014
Last updated
03/17/2018
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