Organization
GENESIS HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK G ROGERS (VP OF FINANCE / CFO)
(563) 421-6513
Entity
Organization
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(563) 421-3408
(563) 421-3419
Mailing address
PO BOX 310083, DES MOINES, IA 50331-0083
(563) 421-3408
(563) 421-3419
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TH0004X
Health Psychologist
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
08/29/2019
Last updated
09/11/2019
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