Organization
THE GASTROENTEROLOGY CLINIC, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL PEASLEY DO (PHYSICIAN)
(319) 758-9075
Entity
Organization
Contact information
Practice address
1223 S GEAR AVE, SUITE 201, WEST BURLINGTON, IA 52655-1682
(319) 758-9075
(319) 758-9079
Mailing address
1223 S GEAR AVE, SUITE 201, WEST BURLINGTON, IA 52655-1682
(319) 758-9075
(319) 758-9079
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
03066
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1151191
—
IA
01
—
58751
BLUE CROSS
IA
01
—
DE9199
RR MEDICARE
IA
Enumeration date
06/10/2006
Last updated
03/17/2008
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