Provider Demographics
NPI:1215920020
Name:MARSHALLTOWN ORTHOPAEDICS PC
Entity type:Organization
Organization Name:MARSHALLTOWN ORTHOPAEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-752-7191
Mailing Address - Street 1:312 E MAIN ST
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-1888
Mailing Address - Country:US
Mailing Address - Phone:641-752-7191
Mailing Address - Fax:641-752-2781
Practice Address - Street 1:312 E MAIN ST
Practice Address - Street 2:SUITE 2400
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-1888
Practice Address - Country:US
Practice Address - Phone:641-752-7191
Practice Address - Fax:641-752-2781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARSHALLTOWN ORTHOPAEDICS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-26
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07843OtherWELLMARK BCBS
IA0078436Medicaid
IA0299100001OtherMEDICARE DURABLE MED EQUI
IA0078436Medicaid