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Organization

METRO OB GYN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JORGE F SOTOLONGO M.D. (PRESIDENT)
(712) 329-5700
Entity
Organization

Contact information

Practice address
201 RIDGE ST, #307, COUNCIL BLUFFS, IA 51503-4643
(712) 329-5700
(712) 329-5759
Mailing address
201 RIDGE ST, #307, COUNCIL BLUFFS, IA 51503-4643
(712) 329-5700
(712) 329-5759

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
363A00000X
Physician Assistant
367A00000X
Advanced Practice Midwife

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0462903
IA
Enumeration date
07/17/2006
Last updated
04/22/2014
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