| State University Of Iowa | |
|
109 W Jayne St Lone Tree IA 52755-7771 | |
| (319) 629-4214 | |
| Not Available |
| Full Name | State University Of Iowa |
|---|---|
| Speciality | Family Medicine |
| Location | 109 W Jayne St, Lone Tree, Iowa |
| Authorized Official Name and Position | Sherri A Steckroth (DIRECTOR JOPFS) |
| Authorized Official Contact | 3193563486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State University Of Iowa 200 Hawkins Dr Iowa City IA 52242-1007 Ph: () - | State University Of Iowa 109 W Jayne St Lone Tree IA 52755-7771 Ph: (319) 629-4214 |
| NPI Number | 1841249687 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 12/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841249687 | NPI | - | NPPES |
| CH4836 | Other | IA | RR MEDICARE |
| 0223545 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |