Provider Demographics
NPI:1427067214
Name:IOWA DERMATOLOGY CLINIC PLC
Entity type:Organization
Organization Name:IOWA DERMATOLOGY CLINIC PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:KARAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:515-226-3116
Mailing Address - Street 1:6000 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8203
Mailing Address - Country:US
Mailing Address - Phone:515-226-3116
Mailing Address - Fax:515-391-9262
Practice Address - Street 1:3613 BEAVER AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-3273
Practice Address - Country:US
Practice Address - Phone:515-277-2813
Practice Address - Fax:515-277-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty