1881644466 NPI number — MUSCATINE PHYSICAL THERAPY SERVICES, P.C.

Table of content: ROBERT LYNN COX CDCA (NPI 1487171773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881644466 NPI number — MUSCATINE PHYSICAL THERAPY SERVICES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MUSCATINE PHYSICAL THERAPY SERVICES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881644466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2109 CEDARWOOD DR
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
MUSCATINE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52761-2661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-288-6787
Provider Business Mailing Address Fax Number:
563-288-6719

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2109 CEDARWOOD DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
MUSCATINE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52761-2661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-288-6787
Provider Business Practice Location Address Fax Number:
563-288-6719
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KRAUSHAAR
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
OLINGER
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
563-288-6787

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CJ9921 . This is a "RAILROAD MEDICARE RETIREM" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: F236677 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 49794 . This is a "WELLMARK OF IOWA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: IA0100 . This is a "JOHN DEERE HEALTH PLAN" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0263715 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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