Organization
RADIATION ONCOLOGY SERVICES OF DUBUQUE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY GATES LALLY (OFFICE MANAGER)
(563) 556-2097
Entity
Organization
Contact information
Practice address
350 N GRANDVIEW AVE, WENDT CANCER CENTER, DUBUQUE, IA 52001-6388
(563) 589-2468
Mailing address
120 BRYANT ST, SUITE 105, DUBUQUE, IA 52003-7403
(563) 556-2097
(563) 556-1570
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
52438
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002154
—
IA
05
—
32883000
—
WI
01
—
547180
DEAN HEALTH PLANS
WI
01
—
IA0100
JOHN DEERE HEALTH PLANS
IA
Enumeration date
05/16/2006
Last updated
04/20/2008
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