Organization
MARSHALLTOWN ANESTHESIOLOGISTS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P BLACK MD (PARTNER)
(641) 752-7149
Entity
Organization
Contact information
Practice address
312 E MAIN ST, SUITE 2300 MARSHALLTOWN ANESTHESIOLOGISTS PLC, MARSHALLTOWN, IA 50158-1888
(641) 752-7149
(641) 752-6320
Mailing address
312 E MAIN ST, SUITE 2300 MARSHALLTOWN ANESTHESIOLOGISTS PLC, MARSHALLTOWN, IA 50158-1888
(641) 752-7149
(641) 752-6320
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017038
—
IA
01
—
41903
WELLMARK BCBS OF IA
IA
01
—
CE9564
PGBA PR MEDICARE
—
Enumeration date
11/11/2005
Last updated
06/20/2013
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