Organization
UNDERWOOD FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK W OGG (ADMINISTRAROR)
(712) 566-9148
Entity
Organization
Contact information
Practice address
401 HIGHWAY ST, UNDERWOOD, IA 51576-0218
(712) 566-9148
(712) 566-9408
Mailing address
401 HIGHWAY ST, PO BOX 218, UNDERWOOD, IA 51576-0218
(712) 566-9148
(712) 566-9408
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A-082459
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0732545
—
IA
01
—
DF0999
RAILROAD MEDICARE
IA
Enumeration date
03/02/2007
Last updated
06/18/2008
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