Organization
CT IMAGING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD PALUSKA MD (ACTING MANAGER)
(641) 683-4451
Entity
Organization
Contact information
Practice address
1001 PENNSYLVANIA AVE, OTTUMWA, IA 52501-6427
(641) 683-4451
(641) 684-2931
Mailing address
1001 PENNSYLVANIA AVE, OTTUMWA, IA 52501-6427
(641) 683-4451
(641) 684-2931
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0200949
—
IA
01
—
20094
BLUE CROSS & BLUE SHIELD
IA
01
—
A002754
CHAMPUS
IA
01
—
IA100
JOHN DEERE HEALTH
IA
Enumeration date
04/26/2006
Last updated
08/22/2020
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