Organization
GENESIS HEALTH SYSTEM
Active
Other names
Genesis Medical Center - CVT Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK J. KLEINSCHMIDT (VICE PRESIDENT OF FINANCE)
(563) 421-6513
Entity
Organization
Contact information
Practice address
1236 E RUSHOLME ST STE 150, DAVENPORT, IA 52803-2433
(563) 421-3990
(563) 421-3933
Mailing address
1236 E RUSHOLME ST STE 150, DAVENPORT, IA 52803-2433
(563) 421-3990
(563) 421-3933
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1600338
—
IA
Enumeration date
05/17/2006
Last updated
07/27/2007
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