Individual
DR. JOSEPH JAY VAVRICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 6TH AVE, DES MOINES, IA 50314-0000
(515) 643-2667
Mailing address
1111 6TH AVE, DES MOINES, IA 50314-0000
(515) 643-2667
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
41006
IA
2085R0204X
Vascular & Interventional Radiology Physician
41006
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0042408
—
IA
Enumeration date
06/14/2010
Last updated
10/26/2016
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