Organization
STATE UNIVERSITY OF IOWA
Active
Other names
UI Family Care Southeast Iowa City
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
1130 S SCOTT BLVD, IOWA CITY, IA 52240-2907
(319) 339-7472
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
—
0223263
—
IA
01
—
CH4835
RR MEDICARE
IA
Enumeration date
05/09/2006
Last updated
03/01/2012
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