Provider Demographics
NPI:1992797062
Name:MEDICAL ARTS PLC
Entity type:Organization
Organization Name:MEDICAL ARTS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:TOBEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO FAAFP
Authorized Official - Phone:712-364-3504
Mailing Address - Street 1:700 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:IDA GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:51445-1601
Mailing Address - Country:US
Mailing Address - Phone:712-364-3504
Mailing Address - Fax:712-364-2539
Practice Address - Street 1:700 E 2ND ST
Practice Address - Street 2:
Practice Address - City:IDA GROVE
Practice Address - State:IA
Practice Address - Zip Code:51445-1601
Practice Address - Country:US
Practice Address - Phone:712-364-3504
Practice Address - Fax:712-364-2539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1143677Medicaid
40993Medicare ID - Type Unspecified