Organization
MESSERLY SURGICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL MESSERLY D.O. (PHYSICIAN)
(563) 927-7401
Entity
Organization
Contact information
Practice address
709 W MAIN ST, SUITE 187, MANCHESTER, IA 52057-1526
(563) 927-7401
Mailing address
709 W MAIN ST, MANCHESTER, IA 52057-1526
(563) 927-7401
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2484
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2070540
—
IA
01
—
38014
BCBS
IA
01
—
DD4760
RAILROAD MEDICARE
IA
Enumeration date
10/19/2007
Last updated
01/20/2012
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