Organization
PHYSICIANS' CLINIC OF IOWA, PC, DEPT OF UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA S COOPER (CEO)
(319) 398-1772
Entity
Organization
Contact information
Practice address
1260 2ND AVE SE, CEDAR RAPIDS, IA 52403-4002
(319) 363-8171
(319) 363-3172
Mailing address
1260 2ND AVE SE, CEDAR RAPIDS, IA 52403-4002
(319) 363-8171
(319) 363-3172
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56513
WELLMARK GROUP NUMBER
IA
Enumeration date
01/12/2007
Last updated
08/22/2020
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