| Ottumwa Psychiatric Clinic Pc | |
|
1112 N Van Buren Ave Suite 2 Ottumwa IA 52501-6416 | |
| (641) 684-7744 | |
| (641) 684-7700 |
| Full Name | Ottumwa Psychiatric Clinic Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1112 N Van Buren Ave, Ottumwa, Iowa |
| Authorized Official Name and Position | Ronald Ray Berges (PRESIDENT/MEDICAL DIRECTOR) |
| Authorized Official Contact | 6416847744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ottumwa Psychiatric Clinic Pc 1112 N Van Buren Ave Suite 2 Ottumwa IA 52501-6416 Ph: (641) 684-7744 | Ottumwa Psychiatric Clinic Pc 1112 N Van Buren Ave Suite 2 Ottumwa IA 52501-6416 Ph: (641) 684-7744 |
| NPI Number | 1548377401 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548377401 | NPI | - | NPPES |
| 2776088 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 02659 (Iowa) | Primary |
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