State University of Iowa

NPI #1992037865 in Riverside, Iowa

Provider Information

NPI Number: 1992037865
Entity Type: Organization
Organization Name: State University of Iowa
Primary Specialty: Family Medicine
Enumeration Date: Feb 3, 2010
Last Updated: Mar 1, 2012

Practice Location

Address: 3056 RIVER CROSSING COURT
City: Riverside
State: Iowa
ZIP Code: 52327-4727
Phone: (319) 467-8355

Authorized Official

Name: PHILIP E ROUDABUSH
Title: DIRECTOR, PATIENT FINANCIAL SERVICE
Phone: (319) 384-2334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Nurse Practitioner - Family — Family	363LF0000X
Family Medicine	207Q00000X	Primary

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