Organization
KIMBERLY K. SCHULZ
Active
Other names
Town Square Dermatology, PLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBIN ANN CHRISTIANSON (PRACTICE ADMINISTRATOR)
(319) 337-4566
Entity
Organization
Contact information
Practice address
1100 6TH ST, SUITE 202, CORALVILLE, IA 52241-1755
(319) 337-4566
Mailing address
1100 6TH ST, SUITE 202, CORALVILLE, IA 52241-1755
(319) 337-4566
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
31541
IA
207N00000X
Dermatology Physician
Primary
32786
IA
363A00000X
Physician Assistant
001292
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0466557
—
IA
05
—
0497545
—
IA
01
—
12-25017718
NPI -SCHULZ
IA
01
—
14-77506814
NPI -WALLING
IA
01
—
17-30128653
NPI - ROBSON
IA
01
—
18-11967219
NPI - MCKEE
IA
05
—
2208108
—
IA
01
—
I20222
PTAN
IA
Enumeration date
07/05/2006
Last updated
10/12/2007
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