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Organization

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERICK LAINE (EXEC VP/COO)
(515) 471-9227
Entity
Organization

Contact information

Practice address
8101 BIRCHWOOD CT, SUITE N, JOHNSTON, IA 50131-2930
(515) 471-9300
(515) 471-9320
Mailing address
PO BOX 717, DES MOINES, IA 50303-0717
(515) 471-9300
(515) 471-9320

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
207RC0001X
Clinical Cardiac Electrophysiology Physician
207RG0100X
Gastroenterology Physician
207RI0200X
Infectious Disease Physician
207RP1001X
Pulmonary Disease Physician
207RR0500X
Rheumatology Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
208100000X
Physical Medicine & Rehabilitation Physician
2084N0400X
Neurology Physician
208600000X
Surgery Physician
208D00000X
General Practice Physician
Primary
208M00000X
Hospitalist Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1366425274
IA
01
CC6519
RR MEDICARE
IA
01
CC6757
RR MEDICARE
IA
01
CC7716
RR MEDICARE
IA
01
CI6362
RR MEDICARE
IA
01
CJ3564
RR MEDICARE
IA
Enumeration date
08/05/2013
Last updated
08/05/2013
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