Organization
STATE UNIVERSITY OF IOWA
Active
Other names
Family Care Center North Liberty
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP E ROUDABUSH (DIRECTOR, PATIENT FINANCIAL SERVICE)
(319) 384-2334
Entity
Organization
Contact information
Practice address
3 LIONS DR, NORTH LIBERTY, IA 52317-9575
(319) 626-5680
(319) 626-5687
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0223479
—
IA
01
—
CH4834
RR MEDICARE
IA
Enumeration date
05/09/2006
Last updated
03/01/2012
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