Organization
STATE UNIVERSITY OF IOWA
Active
Other names
UI Family Care Wapello
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP E ROUDABUSH (DIRECTOR, PATIENT FINANCIAL SERVICE)
(319) 384-2334
Entity
Organization
Contact information
Practice address
218 N 2ND ST, WAPELLO, IA 52653-1202
(319) 523-8205
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0175455
—
IA
01
—
CG4344
RR MEDICARE
IA
Enumeration date
05/05/2006
Last updated
03/01/2012
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