Provider Demographics
NPI:1407139793
Name:BILLY J ALDERTON WOMENS HEALTH PRACTICE LLC
Entity type:Organization
Organization Name:BILLY J ALDERTON WOMENS HEALTH PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDERTON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:319-524-4300
Mailing Address - Street 1:1603 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-3430
Mailing Address - Country:US
Mailing Address - Phone:319-524-4300
Mailing Address - Fax:319-524-5396
Practice Address - Street 1:1603 MORGAN ST
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3430
Practice Address - Country:US
Practice Address - Phone:319-524-4300
Practice Address - Fax:319-524-5396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA097652364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's HealthGroup - Single Specialty