| |
405 Monroe St, Pella, IA 50219-1189 | |
(641) 628-3542 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 405 Monroe St, Pella, Iowa |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003073206 | NPI | - | NPPES |
1003073206 | Medicaid | IA | |
1003073206 | Other | IA | WELLMARK BC/BS |
421440625-04 | Other | IA | UNITED HEALTHCARE |
1003073206 | Other | IA | UNITED HEALTHCARE |
480026192 | Other | IA | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 00607 (Iowa) | Primary |
Mailing Address | Practice Location Address |
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908 Washington St, Pella, IA 50219-1504 Ph: (641) 628-3542 | 405 Monroe St, Pella, IA 50219-1189 Ph: (641) 628-3542 |