Organization
PHYSICIANS' CLINIC OF IOWA, PC, DEPT OF SURGICAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA S COOPER (CEO)
(319) 398-1772
Entity
Organization
Contact information
Practice address
830 4TH AVE SE, CEDAR RAPIDS, IA 52403-2423
(319) 362-5118
(319) 364-0574
Mailing address
830 4TH AVE SE, CEDAR RAPIDS, IA 52403-2423
(319) 362-5118
(319) 364-0574
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56498
WELLMARK GROUP NUMBER
IA
Enumeration date
01/12/2007
Last updated
08/22/2020
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