Organization
HERITAGE EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH GATEWOOD MD (OWNER)
(800) 355-0808
Entity
Organization
Contact information
Practice address
1410 N 4TH ST, CLINTON, IA 52732-2940
(319) 244-3640
Mailing address
PO BOX 8147, PHILADELPHIA, PA 19101-8147
(800) 732-1066
(630) 941-4333
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0222166
—
IA
01
—
12820
BLUE SHIELD
IA
Enumeration date
10/09/2007
Last updated
04/20/2008
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