| Dr Samuel James Rickerl, MD | |
|
121 6th Ave, De Witt, IA 52742-2041 | |
| (563) 357-6980 | |
| (563) 202-5307 |
| Full Name | Dr Samuel James Rickerl |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 121 6th Ave, De Witt, Iowa |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437103736 | NPI | - | NPPES |
| 023235 | Other | HEALTH ALLIANCE | |
| 19351 | Other | MIDLANDS CHOICE | |
| 0137570 | Medicaid | IA | |
| 27198 | Other | IOWA HEALTH SOLUTIONS | |
| 55200 | Other | IA | WELLMARK BC/BS |
| IA0165 | Other | JOHN DEERE HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | MD-31160 (Iowa) | Primary |
| 207V00000X | Obstetrics & Gynecology | 036102988 (Illinois) | Secondary |
| Entity Name | Sioux Valley Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083610190 PECOS PAC ID: 4880501881 Enrollment ID: O20040317001463 |
| Entity Name | Signify Health Medical Associates PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191217001453 |
| Entity Name | Vohra Wound Physicians of the West PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205176096 PECOS PAC ID: 5890931331 Enrollment ID: O20201230000094 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Samuel James Rickerl, MD 121 6th Ave, De Witt, IA 52742-2041 Ph: (563) 357-6980 | Dr Samuel James Rickerl, MD 121 6th Ave, De Witt, IA 52742-2041 Ph: (563) 357-6980 |