| Wise Mind Iowa, Llc | |
|
1223 Oakes Drive Iowa City IA 52245 | |
| (319) 541-6198 | |
| Not Available |
| Full Name | Wise Mind Iowa, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1223 Oakes Drive, Iowa City, Iowa |
| Authorized Official Name and Position | James Daniel Burkhalter (CEO) |
| Authorized Official Contact | 3195416198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Mind Iowa, Llc 1223 Oakes Drive Iowa City IA 52245 Ph: (319) 541-6198 | Wise Mind Iowa, Llc 1223 Oakes Drive Iowa City IA 52245 Ph: (319) 541-6198 |
| NPI Number | 1750023222 |
|---|---|
| Provider Enumeration Date | 04/13/2022 |
| Last Update Date | 04/25/2022 |
| Certification Date | 04/25/2022 |
| Medicare PECOS PAC ID | 7618356718 |
|---|---|
| Medicare Enrollment ID | O20220621001061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750023222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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