Organization
NEW CENTURY PHYSICIANS OF IOWA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN G HOLTZCLAW MD (OWNER)
(856) 686-4316
Entity
Organization
Contact information
Practice address
800 MERCY DR, COUNCIL BLUFFS, IA 51503-3128
(712) 328-5230
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
275930
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0298018
—
IA
05
—
100251147-00
—
NE
01
—
112607000
DEPT OF LABOR
IA
01
—
34944
BC/BS GRP PROVIDER NUMBER
IA
Enumeration date
07/14/2005
Last updated
12/30/2014
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