Provider Demographics
NPI:1962719476
Name:MARGARET A. SMOLLEN, M.D, P.C.
Entity type:Organization
Organization Name:MARGARET A. SMOLLEN, M.D, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:SMOLLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-887-2229
Mailing Address - Street 1:319 E BLOOMINGTON ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-2103
Mailing Address - Country:US
Mailing Address - Phone:319-887-2229
Mailing Address - Fax:
Practice Address - Street 1:319 E BLOOMINGTON ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2103
Practice Address - Country:US
Practice Address - Phone:319-887-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27112207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL399462015Medicaid
IA0088070Medicaid
IA0088070Medicaid