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Organization

ST LUKES HEALTH RESOURCES

Active
Parent organization
ST LUKES HEALTH SYSTEM, INC
Other names
St Lukes Clinic Network
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST LUKES HEALTH SYSTEM, INC
Authorized official
MR. JAMES L GOBELL (VICE PRESIDENT)
(712) 279-3949
Entity
Organization

Contact information

Practice address
2720 STONE PARK BLVD, ROOM 629, SIOUX CITY, IA 51104-3734
(712) 279-3380
(712) 279-7015
Mailing address
PO BOX 9375, DES MOINES, IA 50306-9375

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RP1001X
Pulmonary Disease Physician
207VM0101X
Maternal & Fetal Medicine Physician
207Y00000X
Otolaryngology Physician
208100000X
Physical Medicine & Rehabilitation Physician
208600000X
Surgery Physician
213ES0103X
Foot & Ankle Surgery Podiatrist
363AM0700X
Medical Physician Assistant
363LF0000X
Family Nurse Practitioner
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CG1061
RR MEDICARE
Enumeration date
06/14/2006
Last updated
11/08/2013
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