Organization
JUDISCH VISION PC
Active
Other names
Rock Judisch Vision Clinic PC
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN PAUL JUDISCH OD (PRESIDENT)
(712) 464-3136
Entity
Organization
Contact information
Practice address
1800 MAIN ST, GOWRIE, IA 50543-0102
(515) 352-3881
(515) 352-3624
Mailing address
1800 MAIN ST, PO BOX 102, GOWRIE, IA 50543-0102
(515) 352-3881
(515) 352-3624
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1862
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0258194
—
IA
01
—
25817
BCBS
IA
01
—
DA3271
RR MEDICARE
IA
Enumeration date
01/16/2007
Last updated
05/07/2021
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